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Proprotein convertase subtilisin/kexin type 9 monoclonal antibodies (PCSK9 mAbs) reduce circulating low-density lipoprotein cholesterol (LDL-C) by controlling the expression of LDL-receptor on the surface of hepatocytes. This meta-analysis aimed at evaluating the efficacy of PCSK9 mAbs on clinical and lipid-lowering outcomes.PubMed, Embase, and ClinicalTrials.gov were searched from inception until November 2020 for randomized controlled trials (RCTs) that compared PCSK9 mAbs with ezetimibe or placebo in patients at high cardiovascular risk.Twenty eight RCTs with a total of 89,115 participants were included. Compared with placebo, PCSK9 mAbs significantly reduced the risk of major adverse cardiac events (MACEs) (RR 0.83, 95% CI 0.79 to 0.88, p 0.00001). However, no difference was observed in occurring MACEs between PCSK9 mAbs and ezetimibe (RR 0.70, 95% CI 0.40 to 1.20, p = 0.20). Secondary analyses show that PCSK9 mAbs were not superior to ezetimibe in preventing stroke (RR 0.38, 95% CI 0.09 to 1.69, p = 0.20), myocardial infarction (RR 0.95, 95% CI 0.47 to 1.90, p = 0.88), and cardiovascular death (RR 0.44, 95% CI 0.14 to 1.43, p = 0.17). Compared with placebo, PCSK9 mAbs significantly reduced the incidence of stroke (RR 0.75, 95% CI 0.66 to 0.86, p 0.0001) and myocardial infarction (RR 0.81, 95% CI 0.76 to 0.87, p 0.00001), but not the risk of cardiovascular death (RR 0.96, 95% CI 0.86 to 1.07, p = 0.45). As for lipid-lowering efficacy, PCSK9 mAbs markedly reduced percent change of LDL-C from baseline to week 12 and 24 compared to ezetimibe or placebo.In patients at high cardiovascular risk, PCSK9 mAbs could effectively reduce MACEs, stroke, and myocardial infarction compared with placebo. However, PCSK9 mAbs were not superior to ezetimibe in preventing adverse cardiovascular events in our study; RCTs with long-term follow-up and cardiovascular events as the research endpoint are still needed.

Summary Observational studies on dietary or circulating magnesium and risk of cardiovascular disease (CVD) in Chronic Kidney Disease (CKD) stage 1–4 have reported no-to-modest inverse associations. 24 h Urinary magnesium concentration (24 h UMg), an indicator of intestinal magnesium absorption, may provide better insight into the connection of CKD progression. We examined 3179 participants aged 18–74 years with CKD stage 1–4 in the Chinese Cohort Study of Chronic Kidney Disease (C-STRIDE) study, a prospective population-based cohort study. Data were analysed using Spearman rank-order correlation coefficients for all comparisons. We also performed a time-to-event analysis of the data using the Kaplan–Meier survival model, Cox proportional hazard model and competing risk Fine and Gray subdistribution hazard model. During a median follow-up of 4.19 years (interquartile range, 3.43–5.09 years), when modelling end-stage renal disease (ESRD), CVD and death, 24 h UMg was associated with risk of CVD (HR, 1.612 (95% CI, 1.056–2.460)), while no significant association with ESRD and death endpoints could be detected. 24 h UMg risk variants display a modest association with CVD in CKD stage 1–4 patients. Trial registration ClinicalTrials.gov Identifier NCT03041987. Registered January 1, 2012. (retrospectively registered) ( https://www.clinicaltrials.gov/ct2/show/NCT03041987?term=Chinese+Cohort+Study+of+Chronic+Kidney+Disease+%28C-STRIDE%29&rank=1 ).

Autosomal dominant polycystic kidney disease (ADPKD) is the most common hereditary kidney disease, with a prevalence of 1/2,500-1/1,000, and it affects 1.25 million people in China. ADPKD is responsible for nearly 5% of end-stage renal disease cases, which leads to a major burden on public health. In 2016, the Chinese working group developed guidelines for the diagnosis and treatment of ADPKD, which promoted the clinical management of ADPKD in China. In the last 3 years, Chinese clinicians have deepened their understanding and standardized the management of ADPKD, and several basic and clinical studies on ADPKD have been conducted. In combination with international guidelines and research results, the working group updated the ADPKD guidelines in China. This guideline includes 5 chapters: introduction, diagnosis, kidney disease progression monitoring, treatment, and family planning. We highlight the main recommendations and suggestions of the ADPKD guidelines in this summary.

Amanita fuliginea (A. fuliginea) poisoning is an uncommon and potentially fatal amatoxin exposure. We present 3 cases of severe A. fuliginea poisoning associated with thrombocytopenia in China. Three patients consumed foraged A. fuliginea and developed nausea, vomiting, abdominal pain, and diarrhea. They were transferred from primary clinics to our hospital 19–39 h after mushroom ingestion. They all presented with acute hepatic injury, coagulopathy, thrombocytopenia (6-41 × 109/L), and positive fecal occult blood. Intravenous fluids and antioxidants were administered immediately after admission. Fibrinogen and platelets were given to patients A, B and C. Patient A developed fulminant liver failure and died on day 5 after mushroom exposure. Patients B and C recovered and were discharged on days 11 and 9, respectively. The main targets of A. fuliginea poisoning are the liver and digestive tract. To our knowledge this is the first report of thrombocytopenia associated with A. fuliginea ingestion.

Device integration is among the current research trends in the area of organic electronics and the development of multifunctional materials is crucial to accelerate the progress of integrated devices, such as organic light-emitting transistors (OLET), organic field-effect optical waveguides (OFEW) and organic electrofluorochromic (OEFC) devices. Herein, two multifunctional materials with different side chains, 2-(4-octyloxyphenyl)anthracene (AntPh-OC8) and 2-(4-octylphenyl)anthracene (AntPh-C8), based on the concept of combining liquid crystal (LC) materials featuring facile processability, highly ordered alignment and effective charge transport and an anthracene conjugated core with strong fluorescence, are designed and successfully synthesized. The photoluminescence quantum yield (PLQY) of AntPh-OC8 and AntPh-C8 is determined to be 40.9% and 37.6%, respectively, which approaches nearly 2-fold that of 2-phenylanthracene (AntPh). Organic light-emitting diodes (OLED) based on AntPh-OC8 confirmed its solid-state blue emission with a current efficiency (CE) of 1.82 cd A−1, whereas the corresponding organic field-effect transistors (OFET) demonstrated the highest hole mobility of up to 2.59 cm2 V−1 s−1. Organic phototransistors (OPT) comprising AntPh-OC8 and AntPh-C8 revealed efficient photoresponsive characteristics of these newly developed materials. These demonstrations indicate the widespread potential of our newly developed materials for applications in multifunctional integrated devices. Moreover, these results indicate the encouraging role of side-chain engineering in the improvement of charge transport and fluorescence characteristics of anthracene derivatives.

Development of a covalent–organic framework (COF)-based Z-scheme heterostructure is a promising strategy for solar energy driven water splitting, but the construction of a COF-based Z-scheme heterostructure with well-defined architecture, large contact area and intimate contact interfaces is scarce. Herein, we fabricated a direct Z-scheme heterostructure COF–metal sulfide hybrid (T-COF@CdS) with shell–core architecture by self-polymerization of 1,3,5-benzenetricarboxaldehyde and 2,4,6-tris(4-aminophenyl)-1,3,5-triazine in situ on CdS. The formed C–S chemical bonding between T-COF and CdS could provide a very tight and stable interface. Owing to the properly staggered band alignment, strong interfacial interaction and large interfacial contact area between T-COF and CdS, a Z-scheme route for charge separation and transfer is realized, resulting in electron accumulation in CdS for H2O reduction. The obtained Z-scheme heterostructure T-COF@CdS-3 exhibits a high apparent quantum efficiency of 37.8% under 365 nm monochromatic light irradiation, and long-term stability arising from shell–core structures in which the T-COF shell protects the catalytic centers of CdS against deactivation, as well as acts as oxidation sites to avoid the photocorrosion of CdS. This work provides a strategy for the construction of a shell–core direct Z-scheme heterostructure photocatalyst for water splitting with high performance., A stable Z-scheme with well-defined architecture by in situ growth of COFs on CdS for photocatalytic water splitting is constructed. The T-COF shell can protect the catalytic center of CdS from deactivation and photocorrosion.

Background Diabetic nephropathy (DN) is the most common causes of end-stage renal disease. Long non-coding RNA cyclin-dependent kinase inhibitor 2B antisense RNA 1 (CDKN2B-AS1) is connected with the development of DN, but the role of CDKN2B-AS1 in DN has not been entirely elucidated. Methods Quantitative real-time polymerase chain reaction (qRT-PCR) was carried out to measure CDKN2B-AS1 and miR-98-5p levels. Cell viability, proliferation, and apoptosis were analyzed with 3-(4, 5-dimethylthiazol-2-yl)-2, 5-diphenyltetrazolium bromide (MTT) or flow cytometry assays. Protein levels were measured by western blotting. The relationship between CDKN2B-AS1 or notch homolog 2 (NOTCH2) and miR-98-5p was verified via dual-luciferase reporter assay. Results CDKN2B-AS1 and NOTCH2 were upregulated in the serum of DN patients and high glucose-disposed human podocytes (HPCs) and human renal tubular cells (HK-2), whereas miR-98-5p was downregulated. High glucose repressed viability and accelerated apoptosis of HPCs and HK-2 cells. CDKN2B-AS1 knockdown impaired high glucose-induced apoptosis and fibrosis of HPCs and HK-2 cells. Mechanistically, CDKN2B-AS1 sponged miR-98-5p to regulate NOTCH2 expression. Also, CDKN2B-AS1 inhibition-mediated effects on apoptosis and fibrosis of high glucose-disposed HPCs and HK-2 cells were weakened by miR-98-5p inhibitor. Also, NOTCH2 knockdown partly reversed miR-98-5p inhibitor-mediated impacts on apoptosis and fibrosis of high glucose-disposed HPCs and HK-2 cells. Conclusion High glucose-induced CDKN2B-AS1 promoted apoptosis and fibrosis via the TGF-β1 signaling mediated by the miR-98-5p/NOTCH2 axis in HPCs and HK-2 cells. Supplementary Information The online version contains supplementary material available at 10.1186/s13098-021-00725-5., Highlights CDKN2B-AS1 was upregulated in DN and high glucose-induced HPCs and HK-2 cells.Inhibition of CDKN2B-AS1 alleviated high glucose-induced apoptosis and fibrosis of HPCs and HK-2 cells.CDKN2B-AS1 regulated NOTCH2 expression via acting as a miR-98-5p sponge. Supplementary Information The online version contains supplementary material available at 10.1186/s13098-021-00725-5.

Kidney injury molecule-1 (KIM-1) has an important role in chronic kidney disease development. The present study aimed to retrospectively analyze patients with idiopathic membranous nephrology (IMN) with different therapeutic outcomes to investigate the association between KIM-1 levels and therapeutic outcomes. A total of 51 patients with IMN and 20 healthy controls were included. Patients were classified into three groups: Spontaneous remission, remission with immunosuppressive therapy (IST) and nonremission with IST. Clinical and biochemical variables were collected. Urinary KIM-1 levels were measured by ELISA and renal KIM-1 expression was evaluated by immunohistochemistry. Patients with IMN were characterized as having elevated urinary and renal KIM-1 levels compared with those in the controls. Significantly increased urinary and renal KIM-1 levels were observed in the nonremission with IST group compared with those in the spontaneous remission group, and the same trend was observed for the plasma anti-podocyte antigen phospholipase A2 receptor antibody levels. Patients with more severe tubular injury (T2 index) presented with significantly higher urinary and renal KIM-1 levels than those with the T0 index. Urinary and renal KIM-1 levels were positively correlated with blood urea nitrogen, serum creatinine, serum cystatin-C, urinary albumin/creatinine ratio, urinary β2-microglobulin and the renal interstitial fibrosis index, and they were negatively correlated with serum albumin. Furthermore, urinary KIM-1 levels were positively correlated with the renal KIM-1 levels. In conclusion, the measurement of urinary and renal KIM-1 levels may be helpful in guiding medication selection and predicting therapeutic outcomes for patients with IMN.

Background Elderly residents in nursing homes are at high risk for dysphagia. However, the prevalence estimates of this condition and its risk factors among this population were inconsistent. Objective To estimate the prevalence of dysphagia and examine its risk factors among the elderly in nursing homes. Methods Electronic database of PubMed, Web of science, Embase for English language, Wangfang, VIP and CNKI for Chinese language were systematically searched to identify relevant observational studies published not later than July 4, 2021. Studies conducted in nursing homes and reported dysphagia assessment methods were included. Results In total, 43 studies involving 56,746 participants were included in this systematic review and meta-Analysis. The overall pooled crude prevalence of dysphagia was 35.9% (95%CI: 29.0%, 43.4%), with high heterogeneity (I2 = 99.5%). There was a statistically significant difference in prevalence estimates with respect to study locations, methods of assessment of dysphagia, dysphagia assessment staff, representativeness of samples, and validity of assessment tools. Pooled estimates indicated that male (OR = 1.13, 95%CI: 1.00, 1.27), cognitive impairment (OR = 2.47, 95%CI: 1.59, 3.84), functional limitation (OR = 2.59, 95% CI: 1.75, 3.84), cerebrovascular disease (OR = 2.90, 95%CI: 1.73,4.87), dementia (OR = 1.50, 95%CI: 1.15, 1.96) and Parkinson’s disease (OR = 1.81, 95%CI: 1.06, 3.08) were significant risk factors for dysphagia. Conclusions The prevalence of dysphagia in nursing homes is relatively high, and with high heterogeneity. Also, many factors were associated with the risk of dysphagia. Further research is needed to identify strategies for management and interventions targeted at these disorders in this population.

Background: We report a case of serum myeloperoxidase (MPO)-anti-neutrophil cytoplasmic antibody (ANCA)-positive hypertrophic pachymeningitis with elevated serum immunoglobulin G (IgG)4.Case presentation: He was a 67-year-old man who appeared headache and hearing loss 7 years ago. He was treated with methylprednisolone and mycophenolate when he was diagnosed with hypertrophic pachymeningitis 2 years ago. He went to the hospital this time because of fatigue and appetite, the results of his blood tests indicated a progressive increase in creatinine and an increase in MPO and IgG4. His kidney biopsy revealed very few infiltrating IgG4-positive cells. Instead, fibrinoid necrosis of arterioles was observed. Considering the clinical process and these findings, the disease was considered more likely to be ANCA-associated hypertrophic pachymeningitis with elevated serum IgG4 level.Conclusions: Our case highlights the importance of the pathological examination and the medical history. Pathological examination and previous medical history play an essential role in the diagnosis of the disease. Only when the disease is correctly diagnosed can it be further treated effectively and get a better prognosis.Data Sources: Data were collected from the patient’s electronic medical records and the hospital laboratory medicine database.

Background: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) may persist in patients with coronavirus disease 2019 (COVID-19) despite receiving standard care.Methods: In this pilot study of hospitalized adult patients (≥18 years of age), with radiologically confirmed pneumonia who were SARS-CoV-2 positive for more than 28 days despite standard care, were assigned to receive standard of care (SOC, grp I) or leflunomide + SOC (grp 2). After 2 weeks, grp 1 and grp 2 patients who continued to be SARS-CoV-2-positive received leflunomide for 14 days while continuing SOC. The primary outcomes were the rate of and time to SARS-CoV-2 clearance and the 14-day and 30-day hospital discharge rate.Results: 12 patients were enrolled in grp 1 and 15 patients were in grp 2. The 14 days SARS-CoV-2 viral clearance rate was 80.0% (12/15) for grp 2 patients receiving leflunomide vs. 16.7% for grp 1 patients (2/12) (p = 0.002). By day 14, the median time to SARS-CoV-2 clearance was 6.0 days (range 1–12, IQR 1–12) for grp 2 patients. In grp 1, two patients converted to viral negative on days 1 and 6 (p = 0.002). The 14-day discharge rate was 73.3% (11/15) for the grp 2 vs. 8.3% (1/12) for grp 1 (p = 0.001). The 30 days discharge rate was 100% (15/15) for the grp 2 vs. 66.7% (8/12) for grp 1. No severe adverse events or deaths were reported.Conclusion: Leflunomide may improve the SARS-CoV-2 clearance rate and discharge rate in patients with refractory COVID-19. The tolerability of the 14–28 days course of treatment with leflunomide is acceptable. These preliminary observations need to be verified by a large sample size and randomized controlled trial.

Background: COVID-19 had caused more than 2.8 million deaths globally, and the epidemic will persist for an extended period of time. We analyzed clinical features of patients in the early stage of the epidemic, so as to deepen the understanding of the disease.Methods: In this retrospective study, we included 84 confirmed cases of COVID-19 during February 1, 2020 and March 31, 2020. Baseline data were used to classify patients as moderate (57%) or severe/critical based on Chinese protocol. We focused on analyzing the differences in chest computed tomography (CT) between the two groups. Results: Of the 84 cases, 50 were male and the median age was 69 years. 55 (65%) patients had comorbidities at admission, more in the severe/critical group (P=0.040). 94% patients had bilateral lesions on CT, up to 68% had lesions involving all lobes. Ground glass opacification (GGO) (96%), consolidation (44%), Linear opacities (50%) and Air bronchogram (23%) were the mainly lesions. The lesion was gradually absorbed over time, but imaging abnormalities can persist for a long time. Compared with moderate cases, the severe/critical group had more pulmonary consolidation changes (P=0.044) and significantly higher CT severity Score (CTSS) (P=0.040). Lymphocyte counts were significantly lower (P=0.011) and NLR were higher (P=0.029) in severe/critical cases. Conclusions: Chest CT showed bilateral and multiple GGO and consolidation mainly. After treatment, pulmonary lesions were gradually absorbed over time, and imaging abnormalities can be persistent for a long time. Lung consolidation, CTSS, comorbidity, lymphocyte counts, and NLR may be predictors of severe COVID-19.

Highlights • The prognosis of critical cases of COVID-19 might be changed if the intervention of EBP was performed timely. • EBP may help to attenuate the progression of ARDS. • Evaluating FDPs as sensitive marker of injury and prognosis of COVID-19 is warranted., COVID-19 associated cytokine storm could induce ARDS rapidly and the patients would require the support of mechanic ventilation. However, the prognosis was not that optimistic. The outcome might be changed if the intervention of EBP was performed timely. We present a case of severe SARS-CoV-2 infection who recovered from cytokine storm.

Obesity-associated podocyte injury increases in parallel with inflammatory responses. Resveratrol, as an anti-inflammatory and antioxidative agent, has been proven to be effective in obesity. The purpose of the present study was to investigate the function of resveratrol in the early stages of podocyte injury in ovariectomized rats fed a high-fat diet (HFD). The 3-month-old female Wistar rats were randomly divided into four groups: Sham operation with a standard diet; sham operation with a HFD; ovariectomy with a HFD (O+H); and ovariectomy plus HFD treatment with resveratrol (40 mg/kg/day) (O+H+R). Following 12 weeks, the weights of the rats were measured and serum was obtained to measure the levels of 17β-estradiol (E2), serum lipids, serum creatinine, fasting blood glucose (FBG) and insulin. Periodic acid-schiff staining was used to detect renal pathological changes. Meanwhile, the expression of the podocyte-associated proteins nephrin and Wilms' tumor-1 was investigated using immunohistochemical staining, and the levels of tumor necrosis factor-α, interleukin-6 and monocyte chemotactic protein-1 in renal tissues were determined using western blotting. Compared with the O+H group, resveratrol significantly reduced the body weight, serum levels of total cholesterol, low-density lipoprotein cholesterol, FBG and insulin resistance, and increased the levels of E2 in obese rats with an ovariectomy combined with an HFD (P

In the polycrystalline SnS semiconductor films, the crystallite size and stoichiometry play a central role in dictating their optoelectronic properties. Most strategies to tailoring these parameters require long-time deposition methods and post-deposition thermal annealing at high temperature under inert atmosphere or sulfur vapor. Here, we report a different strategy of tuning optoelectronic properties of SnS films by controlling the kinetical parameters in a microwave-hydrothermal solution method at low temperatures (50–60 °C). The interaction between microwave radiation and the highly polar thioacetamide (TA, sulfur source) enhances local temperature in the reaction solution and permits a rapid formation of orthorhombic SnS crystallites on glass substrates. For as-deposited SnS films, a lineal dependence is observed of the film thickness, crystallite size and electrical conductivity on the TA concentration. In addition, the microstrain, Sn/S ratio and optical band gap of the films decrease with the concentration of TA, leading to the optimal values for stoichiometry and optical properties of SnS films. The ability to synthesize highly crystalline SnS thin films at high growth rates and low temperatures opens up possibilities to the fabrication of SnS-based optoelectronic devices on plastic substrates.

Background. The prevalence of prediabetes has been increasing significantly in recent years. Individuals with prediabetes have an increased risk of developing diabetes and cardiovascular diseases. The objectives of this study were to identify risk factors for prediabetes and their interactions among the elderly in rural communities of Hunan Province and to provide a scientific basis for prediabetes prevention. Methods. A case-control study was conducted to explore risk factors for prediabetes among the elderly in rural areas. The general sociodemographic information, lifestyle behaviours, and physiological results of elderly individuals with prediabetes and controls were collected by a questionnaire and laboratory testing. Conditional logistic regression was performed to identify the risk factors for prediabetes among the elderly, and additive interactions were used to analyse the interactions between risk factors. Results. A total of 425 elderly subjects with prediabetes were included in the case group, and 425 elderly subjects with normal plasma glucose levels were included in the control group. The main risk factors for prediabetes among the elderly in rural communities of Hunan Province were a family history of diabetes (OR=2.48; 95% CI: 1.13, 5.46), physical inactivity (OR=3.27; 95% CI: 1.95, 5.49), a lack of health literacy on diabetes prevention and control (OR=3.26; 95% CI: 1.62, 6.55), hypertension (OR=2.01; 95% CI: 1.38, 2.93), overweight (OR=2.53; 95% CI: 1.67, 3.81), obesity (OR=3.08; 95% CI: 1.48, 6.40), and a high waist-to-hip ratio (WHR) (OR=2.26; 95% CI: 1.45, 3.51). Additive interactions for prediabetes were detected between a high WHR and physical inactivity, with a relative excess risk due to interaction (RERI) of 6.30 (95% CI: 0.42, 12.18), and between a high WHR and overweight or obesity, with an RERI of 2.92 (95% CI: 0.56, 5.29). Conclusion. The independent risk factors for prediabetes are a family history of diabetes, physical inactivity, a lack of health literacy on diabetes prevention and control, hypertension, overweight or obesity, and a high WHR. A high WHR has additive interactions with physical inactivity and overweight or obesity for the risk of prediabetes. These findings have significant implications for prediabetes prevention among the elderly in rural areas.

Background: Peritoneal dialysis (PD) related infections, such as peritonitis, are still the main obstacle for the development of PD. Prophylactic antibiotic as one of the interventions to prevent early peritonitis was recommended to use before PD catheter insertion by International Society for Peritoneal Dialysis (ISPD) guidelines, In our hospital, however, since 2012, the prophylactic antibiotics for insertion of PD catheters were not allowed to use because of our hospital’s regulation. In order to analyze the outcomes of PD patients without using prophylactic antibiotics before the PD catheter insertion, we compared the PD patients with or without prophylactic antibiotics before PD catheter insertion. Methods: This retrospective study included 247 patients undergoing permanent PD catheter placement with conventional open surgical method consecutively between February 2008 and June 2013. Of these, 154 patients were given intravenous cefazolin, 1.0 g, 0.5–2 h before the procedure (antibiotic group) and 93 patients were not given prophylactic antibiotics (nonantibiotic group). All the patients were administered intermittent PD within 24 h after PD catheter insertion. The early complications and long-term outcomes were recorded respectively. Results: There was no significant difference in the incidence of peritonitis and exit-site/tunnel infection and mechanical complications between the two groups in the first 30 days after the PD catheter implantation. In addition, after 6 years of follow-up, no difference was seen between the two groups in patient survival, technique survival, and peritonitis-free survival. Conclusions: Our study does not show any beneficial effect of antibiotic prophylaxis in reducing the postoperative peritonitis.

Statistical analysis of tunnel fire accidents (TFAs) in China 2000–2016 as related to causes, characteristics, and consequences are discussed in this study with average frequency, time and locations, vehicle types, and regional distribution features revealed. Analysis results indicate that over half of TFAs in China result from vehicle technical problem. The average prevalence of TFAs has increased yearly since 2000 with the majority of incidences occurring in the summer and winter seasons and the autumn season experiencing the least. Fire accident prone locations tend to be at entrance and exit points of highway tunnels with heavy goods vehicles experiencing the largest proportion of TFAs at 58.2%. Countermeasures focusing on improving tunnel safety are recommended.

Our previous study showed that parenteral anticoagulation therapy (PACT) in the context of aggressive antiplatelet therapy failed to improve clinical outcomes in patients undergoing percutaneous coronary intervention for non-ST-segment elevation acute coronary syndrome (NSTE-ACS). However, the role of PACT in patients managed medically remains unknown. This observational cohort study enrolled patients with NSTE-ACS receiving medical therapy from November 2014 to June 2017 in the Improving Care for Cardiovascular Disease in China-Acute Coronary Syndrome project. Eligible patients were included in the PACT group and non-PACT group. The primary outcomes were in-hospital all-cause mortality and major bleeding. The secondary outcome included minor bleeding. Among 23,726 patients, 8,845 eligible patients who received medical therapy were enrolled. After adjusting the potential confounders, PACT was not associated with a lower risk of in-hospital all-cause mortality (adjusted odds ratio (OR), 1.25; 95% confidence interval (CI), 0.92-1.71; P = 0.151). Additionally, PACT did not increase the incidence of major bleeding or minor bleeding (major bleeding: adjusted OR, 1.04; 95% CI, 0.80-1.35; P = 0.763; minor bleeding: adjusted OR, 1.27; 95% CI, 0.91-1.75; P = 0.156). The propensity score analysis confirmed the primary analyses. In patients with NSTE-ACS receiving antiplatelet therapy, PACT was not associated with a lower risk of in-hospital all-cause mortality or a higher bleeding risk in patients with NSTE-ACS receiving non-invasive therapies and concurrent antiplatelet strategies. Randomized clinical trials are warranted to reevaluate the safety and efficacy of PACT in all patients with NSTE-ACS who receive noninvasive therapies and current antithrombotic strategies.

Objective This study investigated the association between job burnout and quality of life (QoL) after acute coronary syndrome (ACS) in a Chinese sample. Methods This was a one-year longitudinal study. Participants included patients with a first episode of ACS who were still employed. The Copenhagen Burnout Inventory (CBI) assessed job burnout before discharge, and QoL was assessed using the Medical Outcome Study 8-Items Short Form Health Survey (SF-8) and the Seattle Angina Questionnaire (SAQ) before discharge (baseline), at one month, six months and 12 months after discharge. Generalized estimating equations determined the association between job burnout and longitudinal changes of QoL. Results All participants were assigned to either a “low job burnout” group (n = 70) or a “high job burnout” group (n = 50), based on the upper quartile of job burnout scores. Longitudinally over 1-year follow-up period, the scores of the SF-8 and SAQ among patients with a high level of burnout were lower than those in the low job burnout group. Job burnout was significantly associated with lower physical and mental health (SF-8), as well as greater physical limitation and lower treatment satisfaction (SAQ) over time. Conclusion Job burnout at baseline predicted slow improvement of QoL after ACS in a Chinese working sample.

Background Since the outbreak of coronavirus disease 2019 in December 2019, more than 8 million cases have occurred worldwide as of June 16, 2020. However, it is important to distinguish COVID-19 from other respiratory infectious diseases, such as influenza. Here, we comparatively described the clinical characteristics of children with COVID-19 and paediatric patients with influenza. Methods In this retrospective, single-centre study, we reviewed the electronic medical records of 585 paediatric patients with COVID-19 or influenza in Wuhan Children’s Hospital, China. Clinical and epidemiological characteristics, laboratory findings, and clinical outcomes were comparatively analysed. Results The median ages were 6.96 years (IQR, 2–10.81) for children with confirmed COVID-19, 2.67 years (IQR, 1.03–15.25) for those with influenza A and 3.67 years (IQR, 1.62–5.54) for those with influenza B. Fever was a symptom in 84 (34.7%) COVID-19 cases, 132 (70.21%) influenza A cases and 111 (74.50%) influenza B cases. The median length of stay (LOS) was 11 (8–15) days for paediatric COVID-19 patients, 4 (3–6) days for influenza A patients and 5 (3–6) days for influenza B patients. Twenty-six (13.98%) influenza A patients and 18 (12.59%) influenza B patients presented with decreased white blood cell counts, while 13 (5.33%) COVID-19 patients presented with decreased white blood cell counts. Eight (3.28%) COVID-19 patients, 23 (12.71%) influenza A patients and 21 (14.79%) influenza B patients experienced lymphocytopenia. Acute cardiac injury occurred in 18 (7.29%) COVID-19 patients, while 37 (19.68%) influenza A and 27 (18.12%) influenza B patients had acute cardiac injury. Conclusion In this study, the illnesses of children with COVID-19 were demonstrated to be less severe than those of paediatric patients with influenza, and COVID-19 patients had milder illness and fewer complications.

(1) Background: Job burnout may affect the prognosis of patients with acute coronary syndrome (ACS) through mechanisms involving heart rate variability (HRV). However, no study has yet examined those potential associations. Hence, we conducted the present study to investigate this issue. (2) Method: Participants included patients who presented with a first episode of ACS and who were employed. The Copenhagen Burnout Inventory (CBI) was used to assess job burnout. Twenty-four-hour ambulatory electrocardiography recorded HRV on four occasions, i.e., during the hospitalization and follow-ups at one, six, and 12 months, respectively. (3) Results: A total of 120 participants who at least completed three Holter examinations throughout the study were enrolled in the final analysis. Job burnout scores at baseline were inversely associated with LnSDNN, LnTP, LnHF, LnLF, LnULF, and LnVLF during the consequent one-year follow-up. Each 1 SD increase in job burnout scores predicted a decline ranging from 0.10 to 0.47 in the parameters described above (all p &lt, 0.05), and all relationships were independent of numerous confounders, including anxiety and depression. (4) Conclusion: High job burnout predicted reduced HRV parameters during the one-year period post-ACS in the working population.

Background Research findings on the relationship between adverse childhood experiences (ACEs) and the risk of cancer were inconsistent. Objective The purpose of this study was to perform a quantitative synthesis of the preceding research findings. Participants and setting System review and meta-analysis. Methods Electronic database of PubMed, Embase, Web of Science and Cochrane Library were systematically searched to identify relevant observational studies published not later than September 9, 2020. Specifically, original articles that reported the risk of cancer in adult populations that experienced ACEs before the age of 18 were selected. All pooled odds ratios (ORs) and 95 % confidence intervals (CIs) were calculated using a random-effects model. Publication bias was examined using funnel plots, and sensitivity analysis was used to explore the stability of the pooled results. Results A total of 18 studies involving 406,210 participants were included in this review. Individuals with 2 or 3 kinds of ACEs (OR = 1.35, 95%CI:1.12,1.62) or at least 4 ACEs (OR = 2.17, 95%CI: 1.76,2.68) were at increased risk of cancer when compared with individuals with no ACEs. Of the different types of ACEs examined, physical abuse (OR = 1.23, 95%CI:1.05,1.43), sexual abuse (OR = 1.26, 95%CI:1.02,1.56), exposure to intimate partner violence (OR = 1.26, 95%CI:1.12,1.41) and financial difficulties in the family (OR = 1.16, 95%CI:1.00,1.33) were associated with the risk of any cancer. Conclusions These findings suggest that multiple ACEs may be a risk factor for cancer development. Therefore, prevention of ACEs and interventions for supporting those affected by ACEs are necessary.

Uromodulin (Umod) is the most abundant constituent of urine in humans and exclusively found in the kidney tubular epithelium. However, the specific role of Umod in renal tubulointerstitial injury is yet to be understood. The present study was conducted with aim of investigating the potential therapeutic mechanism of Umod in the regulation of renal tubulointerstitial injury. Protein expression of Umod in renal tubular epithelial cells was measured with the conduction of Western blot analysis. Enzyme-linked immunosorbent assay and immunofluorescence assay were performed to detect the complement activation products and the activation products of surface deposition. The expression of C1q, C2, C4, B factor, C3, C5, H factor, CD46, CD55, C3aR, and C5aR were determined with the use of reverse-transcription quantitative polymerase chain reaction and Western blot analyses. Subsequently, the unilateral ureteral obstruction (UUO) rat model was established. Renal tubulointerstitial injury was assessed with the application of hematoxylin-eosin staining and Masson staining in rats. UUO rats and normal rats were injected with si-NC or si-Umod and complement inhibitor. UUO rats were observed to have serious impairment of kidney tubule, renal tubular dilation, and epithelial atrophy, with downregulated Umod and activated complement pathway. Silencing of Umod resulted in the activation of complement system while promoting interstitial fibrosis in renal tubules. Moreover, addition of complement inhibitor significantly alleviated the renal tubule injury and fibrosis. Collectively, our study suggests that silencing of Umod mediates the complement pathway, exacerbating renal tubulointerstitial injury in rats, which provides insight into the development of novel therapeutic agents for renal tubulointerstitial injury.

In this paper, computational heat transfer (CHT) equations were solved using the state-of-art quantum computing (QC) technology. The CHT equations can be discretized into a linear equation set, which can be possibly solved by a QC system. The linear system can be characterized by Ax = b. The A matrix in this linear system is a Hermitian matrix. The linear system is then solved by using the HHL algorithm, which is a quantum algorithm to solve a linear system. The quantum circuit requires an Ancilla qubit, clock qubits, qubits for b and a classical bit to record the result. The process of the HHL algorithm can be described as follows. Firstly, the qubit for b is initialized into the phase as desire. Secondly, the quantum phase estimation (QPE) is used to determine the eigenvalues of A and the eigenvalues are stored in clock qubits. Thirdly, a Rotation gate is used to rotate the inversion of eigenvalues and information is passed to the Ancilla bit to do Pauli Y-rotation operation. Fourthly, revert the whole processes to untangle qubits and measure all of the qubits to output the final results for x. From the existing literature, a few 2 × 2 matrices were successfully solved with QC technology, proving the possibility of QC on linear systems [1]. In this paper, a quantum circuit is designed to solve a CHT problem. A simple 2 by 2 linear equation is modeled for the CHT problem and is solved by using the quantum computing. The result is compared with the analytical result. This result could initiate future studies on determining the quantum phase parameters for more complicated QC linear systems for CHT applications.

ObjectivesTo evaluate the prevalence of depressive symptoms and its influencing factors in late pregnancy.DesignCross-sectional study.SettingFourteen community in urban areas of Hengyang City.ParticipantsThe study conducted from July to October 2019, and surveyed 813 women in late pregnancy who lived in urban areas of Hengyang for more than 6 months, signed an informed consent and were without cognitive disorders, severe mental illnesses or other serious diseases.MeasuresPerinatal depression symptoms were evaluated using the Patient Health Questionnaire-9, and perinatal anxiety symptoms were evaluated using the Generalised Anxiety Disorder-7 Scale. Sociodemographic variables, obstetric characteristics, lifestyle behaviours, family factors, social support, sleep quality and self-efficacy were obtained through structured questionnaires.ResultsThe prevalence of depression symptoms among pregnant women in late pregnancy was 9.2% (95% CI 7.2%–11.2%). Protective factor: age between 25 and 29 years (OR=0.398; 95% CI 0.16–0.991). Risk factors: a normal relationship with her mother-in-law (OR=5.309; 95% CI 1.122–4.184), artificial insemination (OR=4.339; 95% CI 1.492–12.623), no exercise during pregnancy (OR=2.666; 95% CI 1.177–6.039), low self-efficacy (OR=4.253; 95% CI 1.518–11.916), low social support (OR=2.371; 95% CI 1.206–4.661), poor sleep quality (OR=2.134; 95% CI 1.131–4.027), existence of anxiety symptoms (OR=17.654; 95% CI 8.494–36.689).ConclusionThe prevalence of depression symptoms is lower than that in developing countries, but due to the large population base of China, the problem should still be taken seriously. To prevent mental disorders of pregnant women, early screening for mental disorders, promotion of healthy lifestyles, mental healthcare during pregnancy and improved family and social support should be implemented during pregnancy nursing.

ObjectiveTo explore the prevalence of depressive symptoms among women in late pregnancy, and assess mediating effect of self-efficacy in the association between family functions and the antenatal depressive symptoms.DesignCommunity-based, cross-sectional study was conducted among women during the third trimester of pregnancy.SettingThis study was conducted among pregnant women registered at community health service centres of urban Hengyang City, China from July to October 2019.Participants813 people were selected from 14 communities by multi-staged cluster random sampling method.Main outcome measuresThe Family Adaptation Partnership Growth Affection and Resolve Index, the General Self-efficacy Scale and Patient Health Questionnaire were used to access family functions, self-efficacy and antenatal depression symptoms, respectively.ResultsIn this study, 9.2% pregnant women reported the symptoms of antenatal depression (95 CI% 7.2% to 11.2%). After adjustment, the results showed that severe family dysfunction (adjusted OR, AOR 3.67; 95% CI 1.88 to 7.14) and low level of self-efficacy (AOR 3.16; 95% CI 1.37 to 7.27) were associated with antenatal depressive symptoms (p<0.05). Furthermore, self-efficacy level partially mediated the association between family functions and antenatal depressive symptoms(β=−0.05, 95% CI −0.07 to −0.03, p<0.05) and the mediating effect accounted for 17.09% of the total effect.ConclusionsThis study reported 9.2% positive rates of antenatal depression symptoms among women in the third trimester of pregnancy in Hengyang city, China. The mediating effect of self-efficacy on the association between family functions and antenatal depression symptoms among women in the third trimester of pregnancy was found in this study, which provide a theoretical basis to maternal and child health personnel to identify high-risk pregnant women and take targeted intervention for them.

ObjectivesTo examine the association between the prevalence of poor sleep quality and depression symptoms among the elderly in the nursing homes of Hunan province in China.Design, Setting and participantsThis was a cross-sectional study investigating 817 elderly people from 24 nursing homes in China’s Hunan province.Main outcome measuresSleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI) such that poor sleep quality was defined as PSQI Score >5. In addition, depression symptoms were assessed using the Geriatric Depression Scale (GDS). Linear regression models and binary logistic regression models were used to analyse the relationship between the prevalence of poor sleep quality and depression symptoms.ResultsThe mean PSQI Score was 8.5±4.9, and the prevalence of poor sleep quality was 67.3%. Additionally, the mean GDS Score was 9.8±7.5, and the prevalence of depression symptoms was 36.0%. Elderly people with poor sleep quality had increased GDS Score (mean difference=2.54, 95% CI 1.66 to 3.42) and increased risk of depression symptoms (OR=3.19, 95% CI 2.04 to 4.98) after controlling for demographics, chronic disease history, lifestyle behaviours, social support, activities of daily living and negative life events.ConclusionsThe prevalence of poor sleep quality was relatively high, and this was associated with increased depression symptoms. Therefore, poor sleep quality could be speculated as a marker of current depression symptoms in the elderly.

Background It is unclear whether short‐term blood pressure variability is associated with renal outcomes in patients with chronic kidney disease. Methods and Results This study analyzed data from participants in the C‐ STRIDE (Chinese Cohort Study of Chronic Kidney Disease) who had chronic kidney disease stages 1 to 4. Short‐term blood pressure variability was measured by calculating the weighted SD (w‐ SD ) of systolic blood pressure ( SBP ). Renal outcomes were defined as dialysis initiation and/or transplantation. Risk factors associated with w‐ SD of SBP were evaluated by linear regression. Associations of short‐term SBP variability with renal outcomes were evaluated by Cox regression. In total, 1421 patients with chronic kidney disease were included in this study (mean age, 49.4±13.6 years; 56.2% men; estimated glomerular filtration rate, 50.5±29.3 mL/min per 1.73 m 2 ; proteinuria, 0.9 [0.3–2.0] g/d). Mean w‐ SD of SBP was 12.6±4.4 mm Hg. w‐ SD of SBP was independently associated with older age, 24‐hour SBP , blood pressure circadian pattern, and angiotensin II receptor blocker treatment. During a median follow‐up of 4.9 years, 237 patients developed renal outcomes (37.01 per 1000 patient‐years). The incidence rate increased across the quartiles of w‐ SD (log‐rank P =0.005). w‐ SD of SBP was associated with an increased risk of renal outcomes, both as a continuous variable (hazard ratio [HR], 1.47; 95% CI, 1.09–1.99) and as a categorical variable (quartile 4 versus quartile 1: HR, 1.60; 95% CI, 1.08–2.36), independent of 24‐hour SBP , daytime SBP , and nighttime SBP . Conclusions Short‐term SBP was independently associated with the risk of dialysis initiation and/or transplantation in patients with chronic kidney disease .

Alport syndrome (AS) is a hereditary nephropathy which is characterized by molecular abnormalities in collagen IV. Here, we report compound mutations of the COL4A3 gene including a novel allele identified in a patient with Alport syndrome. The patient was a 25-year-old Chinese woman. She has a history of proteinuria and hematuria with cleft lip and palate. The pathologic results were consistent with Alport syndrome. The patient received ACEI treatment but did not respond well to the treatment. Sequencing results revealed that the patient carried two heterozygous mutations in the COL4A3 gene, including a known mutation (c.4243G>C, p.G1415R), which was inherited from her father, and a previously undescribed allele (c.4216G>A, p.G1406R) inherited from her mother. To date, at least 294 different variants of COL4A3 have been reported according to the Human Gene Mutation Database (HGMD). Identification of c.4216G>A as a new AS-related mutation may contribute to both genetic diagnosis of AS and further functional study of COL4A3.

OBJECTIVETo evaluate the safety and efficacy of leflunomide for the treatment of refractory COVID-19 in adult patients.DESIGNOpen-label controlled studySETTINGA designated hospital for patients with refractory COVID-19 in Wuhan, China.PARTICIPANTS27 hospitalized adult patients (≥18 years of age) with radiologically confirmed pneumonia and SARS-CoV-2 positive for more than 28 days despite standard care were assigned to receive standard of care (SOC, grp I) or leflunomide + SOC (grp 2). After 2 weeks, grp 1 and grp 2 patients who continued to be SARS-CoV-2-positive received leflunomide for 14 days while continuing SOC.MAIN OUTCOME MEASURESThe primary outcomes were the rate of and time to SARS-CoV-2 clearance and the 14-day and 30-day hospital discharge rate.RESULTSTwelve patients enrolled in grp 1 and 15 patients were in grp 2. The 14 days SARS-CoV-2 viral clearance rate was 80.0% (12/15) for grp 2 patients receiving leflunomide versus 16.7% for grp 1 patients (2/12) (P=0.002). By day 14, the median time to SARS-CoV-2 clearance was 6.0 days (range 1-12, IQR 1-12) for grp 2 patients. In grp 1, two patients converted to viral negative on days 1 and 6 (P=0.002). The 14-day discharge rate was 73.3% (11/15) for the grp 2 versus 8.3% (1/12) for grp 1 (P=0.001). The 30-day discharge rate was 100% (15/15) for the grp 2 versus 66.7% (8/12) for grp 1. No severe adverse events or deaths were reported.CONCLUSIONLeflunomide is effective in enhancing SARS-CoV-2 clearance and hospital discharge in refractory COVID-19 patients. The addition of leflunomide to SOC did not increase adverse events versus SOC. These preliminary observations underscore a need for a randomized clinical study of leflunomide in SARS-CoV-2 infection.WHAT IS ALREADY KNOWN ON THIS TOPICBased on the large numbers of global infected patients of SARS-CoV-2, there will be many patients on persist viral positive which is named refractory covid-19. Specific medication for the treatment of the refractory covid-19 has been approved.Leflunomide has been widely used in rheumatoid arthritis and psoriatic arthritis with good safety and tolerance. Recently, it is found an activity of anti-SARS-CoV-2 in vitro and the effective concentration of leflunomide is within the recognized therapeutic level for rheumatoid arthritis.WHAT THIS STUDY ADDSLeflunomide is effective in enhancing SARS-CoV-2 clearance and hospital discharge in refractory COVID-19 patients. The safety and tolerability of the 14-28-day course of treatment with leflunomide is acceptable.

Background With the increased vulnerability during pregnancy, domestic violence (DV) is a serious threat to the physical and mental health of pregnant women, making it a significant issue in public health initiatives. In China, family is of great significance to pregnant women, but few scholars have focused specifically on the relationship between the family factors of pregnant women and DV. This study aimed to explore the prevalence and association between family factors and DV among women in late pregnancy, to provide evidence for the prevention of domestic violence during pregnancy. Methods A cross-sectional survey was conducted from July–October, 2019 among pregnant women in urban communities of Hengyang City, Hunan Province, China. A total of 813 participants were included by a multi-staged cluster random sampling method. DV was assessed by the Abuse Assessment Screen Questionnaire (AAS). A multivariate binary logistic regression model was used to evaluate the relationship between family factors and DV. Results Ultimately, 127 (15.62%) participants were identified as victims of DV. After adjustment, the potential risk factors of DV were tensions between their mother-in-law and other family members (OR: 2.85; 95% CI: 1.29 to 6.30 and OR: 3.30; 95% CI: 1.57 to 6.93), medium household debt (OR: 2.17; 95% CI: 1.18 to 4.00), middle and low family APGARI (OR: 2.01; 95% CI: 1.30 to 3.13 and OR: 4.01; 95% CI: 2.09 to 7.69). Conclusions In summary, women in late pregnancy were at higher risk of DV in the family with tensions, medium household debt and family dysfunction, which may help medical personnel intervene in cases of domestic violence against pregnant women in a reasonable and timely manner.

Our study aims to explore the risk factors for suicidal ideation and their interaction among the elderly in nursing homes in Hunan province, China. A cross-sectional study was conducted among the elderly in nursing homes in Hunan Province. Twenty-four nursing homes were selected by multistage cluster random sampling, and 817 elderly residents were investigated using a set of structured questionnaires. The main outcome measures included general information, suicidal ideation, depression symptoms, social support, activities of daily living (ADL), stressful life events, and sleep quality. Multivariate binary logistic regression was performed to explore the risk factors for suicidal ideation among the elderly in nursing homes, and additive interaction was used to analyze the interaction between risk factors. The prevalence of suicidal ideation among the elderly in nursing homes in Hunan province was 17.9% (95% confidence interval(CI): 15.2%, 20.6%). Living in a rural area (odds ratio(OR)=1.88, 95% CI: 1.03, 3.44), infrequent visits from relatives (OR=2.61, 95% CI: 1.42, 4.78), history of chronic disease (OR=2.34, 95% CI: 1.09, 5.01), depression symptoms (OR=8.11, 95% CI: 4.52, 14.54), lower social support (OR=3.85, 95% CI: 1.94, 7.61), and ADL disability status (OR=4.38, 95% CI: 2.10, 9.14) increased the risk of suicidal ideation. Additive interactions were detected between depression symptoms and ADL status, with a relative excess risk due to interaction (RERI) of 8.73 (95% CI: 2.04, 15.43), and between depression symptoms and social support, with an RERI of 5.98 (95% CI: 0.86, 11.10). The prevalence of suicidal ideation among the elderly in nursing homes is relatively high. Both physical conditions and psychosocial factors were associated with suicidal ideation among the elderly. These findings have significant implications for the prediction and prevention of suicidal behaviors.

In recent years, photodetectors based on organic-inorganic lead halide perovskites have been studied extensively. However, the inclusion of lead in those materials can cause severe human health and environmental problems, which is undesirable for practical applications. Here, we report high-performance photodetectors with a tin-based perovskite/PEDOT:PSS vertical heterojunction. The device demonstrates a broadband photoresponse from NIR to UV. The maximum responsivity and gain are up to 2.6 × 106 A/W and 4.7 × 106, respectively. Moreover, a much shorter response time and higher detectivity can be achieved by reducing the thickness of PEDOT:PSS. The outstanding performance is due to the excellent optoelectronic properties of the perovskite and the photogating effect originating from the heterojunction. Furthermore, devices fabricated on flexible substrates can demonstrate not only high sensitivity but also excellent bending stability. This work opens up the opportunity of using lead-free perovskite in highly sensitive photodetectors with vertical heterojunctions.

The study explored the correlations of tumor necrosis factor-α (TNF-α) and interleukin-1β (IL-1β) gene polymorphisms with susceptibility and the condition of primary nephrotic syndrome. A total of 200 patients with primary nephrotic syndrome in Qilu hospital were collected as disease group, and 200 healthy people were selected as control group. Genomic deoxyribonucleic acids (DNAs) of nucleated cells in the peripheral blood were extracted to detect the gene polymorphisms of TNF-α (rs1799724 and rs1800629) and IL-10 (rs1800872 and rs141219090). Allele distributions at rs1799724 (P=0.003) and rs1800629 (P=0.011) of TNF-α gene and at rs1800872 (P=0.033) of IL-10 gene in disease group were different from those in control group. In the disease group, allele C frequency at rs1799724 and allele A frequency at rs1800629 of TNF-α gene and allele T frequency at rs1800872 of IL-10 gene were higher. There were differences between rs1799724 (P=0.007) and rs1800629 (P=0.002) of TNF-α gene. In addition, there was a difference in the frequency of the dominant model of TNF-α gene rs1800629 between disease group and control group (P=0.035), and the frequency of dominant model GG+GA was remarkably lower in the disease group. Additionally, TT genotype at rs1799724 of TNF-α gene was obviously related to the plasma TNF-α level (P

Objective. To examine whether comorbidity with type 2 diabetes (T2D) affects the clinical and hematological parameters of coronavirus disease 2019 (COVID-19) patients. Methods. We retrospectively investigated the clinical, imaging, and laboratory characteristics of patients with confirmed COVID-19 who were hospitalized from January 30, 2020 to March 17, 2020, at the Renmin Hospital of Wuhan University. A detailed clinical record was kept for each subject, including the medical history of COVID-19 and physical and laboratory examinations. A total of 164 subjects were eligible for the study, among which 40 patients were comorbid with T2D. Further analysis was conducted in two subcohorts of sex- and age-matched patients with and without T2D to identify hematological and biochemical differences. The laboratory tests, including routine blood tests, serum biochemistry, and coagulation function, were performed upon admission. Results. The two groups showed no significant differences in baseline parameters, including age, sex, chest X-ray, or computed tomography (CT) findings, upon admission. However, patients with T2D showed an increased incidence of diarrhea. T2D patients required more recovery time from pneumonia, as shown by follow-up CT findings, which might contribute to the prolonged hospitalization. Comorbidity with T2D also increased risk of secondary bacterial infection during COVID-19. The T2D group had significantly higher white blood cell and neutrophil counts compared with the nondiabetic group, but T2D patients suffered from more severe lymphocytopenia and inflammation ( P < 0.05 ). Most biochemical parameters showed no significant differences between the two groups ( P > 0.05 ). However, patients with T2D seemed to have a significantly higher risk of developing hyperlactatemia, hyponatremia, and hypocalcemia. Conclusions. COVID-19 patients comorbid with T2D demonstrated distinguishing clinical features and hematological parameters during the infection. It is necessary to develop a different clinical severity scoring system for COVID-19 patients with T2D. This study may provide helpful clues for the assessment and management of COVID-19 in T2D patients.

Background. COVID-19 caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has threatened every civilian as a global pandemic. The immune system poses the critical interactive chain between the human body and the virus. Here, we make efforts to examine whether comorbidity with type 2 diabetes (T2D) affects the immunological response in COVID-19 patients. Methods. We conducted a retrospective pilot study investigating immunological characteristics of confirmed cases of COVID-19 with or without comorbid T2D. Two subcohorts of sex- and age-matched participants were eligible for data analysis, of which 33 participants were with T2D and the remaining 37 were nondiabetic (NDM). Cellular immunity was assessed by flow cytometric determination of surface markers including CD3, CD4, CD8, CD19, CD16, and CD56 in peripheral blood. Levels of C reactive protein, immunoglobulin (IgG, IgM, IgA, and IgE), and complements (C3, C4) were detected by rate nephelometry immunoassay. And Th1/Th2 cytokines (IL-2, IL-4, IL-6, IL-10, TNF-α, and IFN-γ) were detected by Cytometric Bead Array. Results. Neutrophil counts were found to be significantly higher in the T2D group than in the NDM group and had a significant relevance with clinical severity. Lymphocyte frequencies showed no significant differences in the two groups. However, the proportions and absolute counts of T, Tc, Th, and NK cells decreased in both groups to different degrees. An abnormal increase in neutrophil count and a decrease in lymphocyte subpopulations may represent risk factors of COVID-19 severity. The level of IgG, IgM, IgA, C3, and C4 showed no significant difference between the two groups, while the IgE levels were higher in the T2D group than in the NDM group ( p < 0.05 ). Th1 cytokines including IFN-γ, TNF-α, and IL-6, as well as CRP, appeared significantly higher in the T2D group. Conclusions. The COVID-19 patients comorbid with T2D demonstrated distinguishable immunological parameters, which represented clinical relevancies with the predisposed disease severity in T2D.

To follow up the participants of the randomized clinical trial “Efficacy and Safety of Niaoduqing Particles (尿毒清颗粒) for Delaying Moderate-to-Severe Renal Dysfunction”, and assess the long-term effects of Niaoduqing Particles on delaying the progression of renal dysfunction. Participants, who had previously been randomly assigned to receive Niaoduqing Particles or placebo for 24 weeks (146 cases in each group), were invited to follow-up and all were administered Niaoduqing Particles 5 g thrice daily and 10 g before bedtime for 24 weeks. The primary endpoints were changes in baseline serum creatinine (Scr) and estimated glomerular filtration rate (eGFR) after completion of the open-label treatment period. After the double-blind period, the median (interquartile range) changes in Scr were 1.1 (–13.0–24.1) and 11.7 (–2.6–42.9) μmol/L for the Niaoduqing Particle and placebo groups, respectively (P=0.008), and the median changes in eGFRs were–0.2 (–4.3–2.7) and–2.21 (–5.7–0.8) mL•min-1•1.73 m-2, respectively (P=0.016). There were significant differences in the double-blind period changes in renal function between groups. After the open-label period, the median changes in Scr were 9.0 (–10.0–41.9) and 17.5 (–6.0–50.0) μmol/L for the Niaoduqing Particle and placebo groups according to baseline grouping, respectively (P=0.214), and the median changes in eGFRs were–2.3 (–6.4–1.9) and–3.7 (–7.5–1.1) mL•min-1•1.73 m-2, respectively (P=0.134). There were no statistical differences in the open-label period changes in renal function between groups. The eGFR reduction of participants who accepted Niaoduqing Particle treatment for 48 weeks was projected to 2.5 mL•min-1•1.73 m-2 per year. Niaoduqing Particles appear to have long-term efficacy for patients with moderate-to-severe renal dysfunction. Although there was no statistical difference, the early use of Niaoduqing Paticles seems to ameliorate the worsening of renal function. (Trial registration No. ChiCTR-TRC-12002448)

Background: In chronic kidney disease (CKD), endothelin-1 (ET-1) always increases and there are changes in cardiac ultrasonography. In the present study, we aimed at investigating the role of serum ET-1 in predicting cardiac complications in patients with CKD. Methods: The level of serum ET-1 was measured by enzyme-linked immunosorbent assay (ELISA) and cardiac ultrasonography was performed in enrolled patients. Indexes of heart failure, such as left ventricular mass index, interventricular septum thickness and left ventricular end diastolic diameter, were measured in patients with CKD. Results: In the present study, we found that the level of serum ET-1 was significantly correlated with left ventricular mass index, interventricular septum thickness and left ventricular end diastolic diameter (p

Interface losses at metal/organic interface is a critical issue in organic electronic devices. The interfacial layers play a significant role in enhancing the device performance and the interfacial material design criteria are ongoing challenges to be faced in optimization the device performance. In this work, a simple Phenanthroline derivative Phen-I was synthesized through a quaternization reaction in a high yield without complicated purification process. Besides its good wettability and compatibility of the contact between metal electrode and organic layer, interestingly, Phen-I displays a dual functional property, i.e., it not only lowers the work function of the metallic cathode to increase electron extraction but also can be doped into electron transporting material to enhance the conductivity. The inverted perovskite solar cells (PSCs) with Phen-I as cathode interlayer (CIL) show superior performance both in power conversion efficiency, with a maximum PCE of 18.13%, and devices stability as compared with the control devices. Encouragingly, the best PCE of 19.27% was obtained when the perovskite layer based on FA0.3MA0.7PbI2.7Cl0.3 perovskite system. Meanwhile, the devices with Phen-I as CIL show low J-V hysteresis during the forward and reverse bias sweeping. Subsequent studies demonstrate that the performance of the inverted PSCs also improves to 15.25% using 5% Phen-I:PC61BM as electron transporting layer (ETL). Herein, the interface between the metal electrode and ETL is carefully investigated using a series of electrical and surface potential techniques. These results demonstrate that Phen-I is a dual-functional interlayer material to reduce interface losses, which, highlights the broad promise of this new class of materials for applications in organic electronic devices. Meanwhile, owing to the simple molecular structure, low-cost and solution processible, these intriguing features render Phen-I more suitable for efficient organic electronics in large area printing process.

Linear codes with few weights have applications in data storage systems, secret sharing schemes and authentication codes. In this paper, inspired by the butterfly structure [6] , [29] and the works of Li, Yue and Fu [21] and Jian, Lin and Feng [19] , we introduce a new defining set with the form of the closed butterfly structure and consequently we obtain three classes of 3-weight binary linear codes and a class of 4-weight binary linear codes whose dual is optimal. The lengths and weight distributions of these four classes of linear codes are completely determined by some detailed calculations on certain exponential sums. Computer experiments show that many (almost) optimal codes can be obtained from our construction.

Background Whether persistent hematuria in patients with antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) during clinical remission reflects active disease or chronic glomerular injury is uncertain. This study aimed to investigate the significance of persistent hematuria during clinical remission in a large cohort of AAV patients. Methods A cohort of 219 AAV patients in complete clinical remission after induction therapy at our center was retrospectively studied, and their clinical and laboratory data as well as long-term outcomes were analyzed. Results A total of 80 out of 219 patients had persistent hematuria during clinical remission of AAV. Compared with patients without hematuria during remission, the slope of eGFR decline in patients with persistent hematuria was significantly higher during the long-term follow-up [3.6 (IQR 1.2, 7.2) vs. 1.5 (IQR 0.2, 4.0) mL/min/1.73 m2/year, P

Background: Chronic kidney disease (CKD) with moderate-to-severe renal dysfunction usually exhibits an irreversible course, and available treatments for delaying the progression to end-stage renal disease are limited. This study aimed to assess the efficacy and safety of the traditional Chinese medicine, Niaoduqing particles, for delaying renal dysfunction in patients with stage 3b-4 CKD. Methods: The present study was a prospective, randomized, double-blind, placebo-controlled, multicenter clinical trial. From May 2013 to December 2013, 300 CKD patients with an estimated glomerular filtration rate (eGFR) between 20 and 45 ml·min −1 ·1.73 m −2 , aged 18–70 years were recruited from 22 hospitals in 11 Chinese provinces. Patients were randomized in a 1:1 ratio to either a test group, which was administered Niaoduqing particles 5 g thrice daily and 10 g before bedtime for 24 weeks, or a control group, which was administered a placebo using the same methods. The primary endpoints were changes in baseline serum creatinine (Scr) and eGFR after completion of treatment. The primary endpoints were analyzed using Student's t -test or Wilcoxon's rank-sum test. The present study reported results based on an intention-to-treat (ITT) analysis. Results: A total of 292 participants underwent the ITT analysis. At 24 weeks, the median (interquartile range) change in Scr was 1.1 (−13.0–24.1) and 11.7 (−2.6–42.9) μmol/L for the test and control groups, respectively ( Z = 2.642, P = 0.008), and the median change in eGFR was −0.2 (−4.3–2.7) and −2.2 (−5.7–0.8) ml·min −1 ·1.73 m −2 , respectively ( Z = −2.408, P = 0.016). There were no significant differences in adverse events between the groups. Conclusions: Niaoduqing particles safely and effectively delayed CKD progression in patients with stage 3b-4 CKD. This traditional Chinese medicine may be a promising alternative medication for patients with moderate-to-severe renal dysfunction. Trial Registration: Chinese Clinical Trial Register, ChiCTR-TRC-12002448; http://www.chictr.org.cn/showproj.aspx?proj=7102 .

Though poly(3-hexylthiophene) (P3HT) is one of the most commonly used polymers in organic solar cells, a broad range of values, derived from cyclic voltammetry (CV), has been reported for the lowest unoccupied molecular orbital (LUMO) position (from −3.53 to −2.70 eV); contrastingly, the highest occupied molecular orbital (HOMO) position is reported in a narrow range (from −4.92 to −5.20 eV). As a consequence of this wide distribution for the LUMO position, most researchers choose to use electrochemical techniques for determining only the HOMO position, and estimate the LUMO position by adding the experimental optical band-gap value. Here, three different electrochemical strategies (CV, potentiostatic EIS, and potentiodynamic EIS) for obtaining the HOMO and LUMO position for P3HT films formed under ambient conditions on transparent conductive substrates (indium tin oxide (ITO) glass) are compared. The results are discussed in the frame of limitations of each technique. The cyclic voltammetric response and the data derived from potentiostatic EIS using electric equivalent circuits include the response of all processes involved in the measurements, particularly masking the LUMO response due to the presence of energetic states. In contrast, potentiodynamic EIS measured in a wide frequency range results in a more reliable approach since it allows discerning between middle-frequency-dependent processes associated with energetic states in the gap of the P3HT/ITO films, and low-frequency-dependent processes associated with filling and emptying of LUMO and HOMO states, respectively. It is a powerful and simple method to analyze the electronic structure of semiconductor organic thin films.

When ischemic stroke occurs, oxygen and energy depletion triggers a cascade of events, including inflammatory responses, glutamate excitotoxicity, oxidative stress, and apoptosis that result in a profound brain injury. The inflammatory response contributes to secondary neuronal damage, which exerts a substantial impact on both acute ischemic injury and the chronic recovery of the brain function. Microglia are the resident immune cells in the brain that constantly monitor brain microenvironment under normal conditions. Once ischemia occurs, microglia are activated to produce both detrimental and neuroprotective mediators, and the balance of the two counteracting mediators determines the fate of injured neurons. The activation of microglia is defined as either classic (M1) or alternative (M2): M1 microglia secrete pro-inflammatory cytokines (TNFα, IL-23, IL-1β, IL-12, etc) and exacerbate neuronal injury, whereas the M2 phenotype promotes anti-inflammatory responses that are reparative. It has important translational value to regulate M1/M2 microglial activation to minimize the detrimental effects and/or maximize the protective role. Here, we discuss various regulators of microglia/macrophage activation and the interaction between microglia and neurons in the context of ischemic stroke.

In inverted planar heterojunction (PHJ) perovskite solar cells (PSCs), the interface layer between the electron transporting layer and the cathode plays a very important role in achieving high power efficiency. Herein, we present the synthesis of a new water/alcohol soluble small molecular cationic compound based on the naphthalene diimide functionalized pyridinium salt, N,N′-bis(1-n-hexylpyridinium-4-ylmethyl)-1,4,5,8-naphthalenetetracarboxydiimide (PN6). PN6 exhibits a large band gap (2.95 eV), high electron mobility (7.1 × 10−5 cm2 V−1 s−1), deep LUMO energy level (−4.07 eV) and can easily form highly transparent thin films. By introducing it as a cathode interface layer in PHJ PSCs, PN6 can effectively decrease the work function of the cathode, boosting all the photovoltaic parameters of the fabricated devices. By using PN6 in the ITO/NiOx/perovskite/PC61BM/PN6/Ag device structure, a power conversion efficiency (PCE) of 17.27% is obtained. Moreover, it is observed that the performance of PHJ PSCs with the PN6 interface layer is insensitive to the interlayer thickness and even at a thickness of 30 nm; the PCE of the device can still reach up to 15.37%, which makes it compatible with large-area roll-to-roll processing technology. These results demonstrate that the naphthalene diimide functionalized pyridinium salt can be a new category of water/alcohol soluble cathode interface material for high performance PHJ PSCs.

Tetracene, one of the polyacene derivatives, shows eminent optical and electronic properties with relatively high stability. To take advantage of the intrinsic properties of the tetracene molecule and explore new semiconductors, herein, we report the design and synthesis of two novel p-channel tetracene derivatives, 2-(4-dodecyl-phenyl)-tetracene (C12-Ph-TET) and 2-phenyl-tetracene (Ph-TET). Top contact OTFTs were fabricated using these two materials as semiconductor layers, with charge mobilities up to 1.80 cm2 V−1 s−1 and 1.08 cm2 V−1 s−1, respectively. Our molecular modeling results indicate that the introduction of phenyl into tetracene can improve the efficient charge transport in electronic devices as a result of the increased electronic coupling between the two neighboring planes of the molecules. AFM images of the thermally evaporated thin films of these two materials show large grains, which correspond to the high mobilities of these devices. Consequently, the mobility of our OTFTs based on C12-Ph-TET is the highest for OTFTs based on tetracene derivatives reported to date. The single crystal analyses show the existence of π–π stacking interactions within the molecules with the introduction of mono-phenyl substituents, which is the main cause of the increased mobility. The impressive properties of these two materials indicate that the introduction of alkyl-phenyl and phenyl group could be an excellent method to improve the properties of the organic semiconductor materials.

Background Sleep problems have become the most common complaints among the elderly. There are a few studies that explored the prevalence of poor sleep quality and its associated factors among the elderly in nursing homes. Therefore, this study aimed to examine the prevalence of poor sleep quality and its associated factors among the Chinese elderly in nursing homes. Methods A total of 817 elderly residents, from 24 nursing homes, were included in this cross-sectional study. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI), and poor sleep quality was defined as PSQI >5. Multiple binary logistic regression was used to estimate the strength of the association between risk factors and poor sleep quality in terms of adjusted odds ratios (AORs) and their 95% confidence intervals (CIs), and interactions of risk factors for poor sleep quality were also examined. Results The prevalence of poor sleep quality was 67.3% (95% CI: 64.0, 70.5%) among the Chinese elderly in nursing homes. Multiple binary logistic regression results showed that participants with the following characteristics had an increased risk of poor sleep quality after adjustments for other confounders: being 70-79 years old (AOR: 1.78, 95% CI: 1.08, 2.92) or 80 years old and above (AOR: 2.67, 95% CI: 1.68, 4.24); having one to two kinds of chronic diseases (AOR: 2.05, 95% CI: 1.39, 3.01) or three or more kinds of chronic diseases (AOR: 2.35, 95% CI: 1.39, 4.00); depression symptoms (AOR: 1.08, 95% CI: 1.04, 1.11), anxiety symptoms (AOR: 1.11, 95% CI: 1.05, 1.18), and social support(AOR: 0.97, 95% CI: 0.95, 0.99). Additive interactions were detected between age and anxiety symptoms (AOR: 8.34, 95% CI: 4.43, 15.69); between chronic disease and anxiety symptoms (AOR: 8.61, 95% CI; 4.28, 17.31); and between social support and anxiety symptoms (AOR: 6.43, 95% CI: 3.22, 12.86). Conclusions The prevalence of poor sleep quality among the elderly in nursing homes is relatively high. Besides, anxiety symptoms has additive interactions with age, chronic disease and social support for poor sleep quality. These findings have significant implications for interventions that aim to improve sleep quality among elderly residents in nursing homes.