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Platinum-based cytotoxic chemotherapy is considered the standard treatment for advanced gastric cancer (GC). However, cisplatin chemoresistance often occurs with the mechanisms being not well clarified, which results in the cancer recurrence and poor survival. Ginsenoside Rg3, isolated from the Chinese Herb Panax Ginseng, is recognized as an anti-cancer agent. Herein, we aimed to reveal whether Ginsenoside Rg3 alleviates cisplatin resistance and sensitizes GC cells to cisplatin-induced apoptosis, and draw out the underlying molecular mechanism in cisplatin-resistant GC cells. The lower expression of miR-429 was found in AGSR-CDDP cells; it was also in association with cisplatin-resistance in GC cells and expression of which was restored following Ginsenoside Rg3 treatment. We also demonstrated that miR-429 made a contribution toward chemosensitivity in GC cells partly through SOX2 regulation. SOX2 was found to contribute to developing platinum resistance and was an authentic target for miR-429 in AGSR-CDDP cells. Importantly, enforced expression of SOX2 with a pcDNA3-SOX2 construct lacking the 3′-UTR miRNA binding site diminished the cytotoxic effects of miR-429 in AGSR-CDDP cells. We demonstrated that Ginsenoside Rg3 enhanced chemosensitivity in AGSR-CDDP GC cells, at least in part, through up-regulating miR-429, thereby targeting SOX2 and modulating downstream PI3K/AKT/mTOR signaling. Ginsenoside Rg3 was also found to regulate apoptosis-related genes via miR-429 in cisplatin-resistant GC cells. Ginsenoside Rg3 treatment significantly suppressed the migration rate of AGSR-CDDP GC cells, while following transfection with anti-miR-429, the anti-migratory effects of Ginsenoside Rg3 was partially abolished. This data suggested that Ginsenoside Rg3 may impede the chemoresistance and migration of GC cells mainly mediated through miR-429. We concluded that miR-429-regulated SOX2 expression was one of the main mechanisms by which Ginsenoside Rg3 dramatically promoted its anticancer effects on cisplatin-resistant GC cells. We also underscored a supporting model in which miR-429 adjusted PI3K/AKT/mTOR signaling by regulating SOX2 in cisplatin-resistant GC cells.

Summary: The protocol outlines the steps for growing silica nanowires on various substrates such as glass and stainless-steel foil. Silica nanowires are grown by thermal chemical vapor deposition via a vapor-liquid-solid mechanism, in which silicon wafers are used as silicon sources and platinum films as catalysts. This protocol can be used to grow silica nanowires on other substrates such as quartz filter, quartz sphere, alumina plate, and silicon wafer, provided the substrate materials can tolerate the temperature during process heating.For complete details on the use and execution of this profile, please refer to Lee et al. (2019), Tsai and Shieh (2019), and Tsai et al. (2021).

With the increasingly severe problem of bacterial resistance, colistin, as the last line of defense, has attracted attention again. Mobile colistin resistance (mcr-1) gene is involved in the horizontal transmission of colistin resistance in Gram-negative bacteria (GNB), which is a serious threat to human health. Therefore, rapid detection of mcr-1 gene presence in clinical samples is crucial. In this study, a Recombinase-aided amplification(RAA) method for mcr-1 was successfully constructed, with sensitivity of 20 copies/reaction. In addition, amplification signal could only be detected in the strain containing mcr-1 gene among 14 different bacterial species. The method was then used to test a total of 672 clinical samples from a pediatric hospital in Beijing. Five strains harbored mcr-1 genes were isolated from mcr-1-positive clinical samples and identified as Escherichia coli. Multi-locus sequence typing (MLST) analysis showed that the five E. coli belonged to different ST types. Notably, the mcr-1 gene from the isolates could be transferred conjugately to the recipient strain E. coli J53, with highest transfer efficiency up to 57–58%, suggesting that the mcr-1 gene was located on the plasmid. These findings showed that the RAA assay has potential to be a rapid and sensitive mcr-1 gene screening test for clinical samples, and mcr-1 could be transmitted vertically and horizontally between and within bacterial species in a plasmid-mediated manner.

PurposeThe purpose of this study is to explore the association of P300 components with clinical characteristics and efficacy of pharmacotherapy in alcohol use disorder (AUD).MethodsOne hundred fifty-one AUD patients and 96 healthy controls were recruited and evaluated for the symptoms of depression, anxiety, sleep, and cognitive function by the Alcohol Use Disorders Identification Test (AUDIT), the 9-item Patient Health Questionnaire (PHQ-9), the 7-item Generalized Anxiety Disorder scale (GAD-7), the Pittsburgh Sleep Quality Index (PSQI), Digit Symbol Substitution test (DSST), and event-related potential P300, which is one of the averaged scalp electroencephalography responses time-locked to specific events. Among the AUD group, 101 patients finished an 8-week pharmacotherapy and were evaluated for the above data at post-intervention.Results1. At baseline, AUD patients had higher scores of AUDIT, PHQ-9, GAD-7, PSQI, and P300 latency at Cz, Pz, and Fz and lower DSST score and smaller P300 amplitudes at Fz, Cz, and Pz compared with controls. P300 components correlated significantly with alcohol dose and score of AUDIT, PHQ-9, GAD-7, PSQI, and DSST. 2. After 8 weeks' treatment, there were significant changes for the P300 components; alcohol dose; and score of AUDIT, PHQ-9, GAD-7, PSQI, and DSST. Variables at baseline, including P300 amplitudes at Fz, Cz, and Pz; latency of Fz and Pz; alcohol dose; and scores of PHQ-9, GAD-7, PSQI, and DSST, were significantly associated with changes of reduction rate of AUDIT scores. However, P300 amplitudes at Fz, Cz, and Pz in AUD patients after 8-week treatment were still significantly shorter than healthy controls (HCs), and P300 latencies at Fz, Cz, and Pz were significantly longer than HCs. 3. When validated area under the receiver operating characteristic curve (AUC) was over 0.80, the baseline variables including amplitudes at Cz and Pz, alcohol dose, and scores of PSQI could predict the changes of reduction rate of AUDIT score.ConclusionP300 amplitudes and latencies at Fz, Cz, and Pz could be used as biological markers for evaluating the clinical characters and severity of AUD. P300 amplitudes at Cz and Pz, sleep condition, and cognitive function at baseline could predict the efficacy of pharmacotherapy for AUD patients.

This study aims to help enterprises enhance their innovation capabilities in the environment of knowledge economy globalization and stand out in the fierce industry competition. Firstly, data on existing higher education theories and innovation theories are analyzed. Secondly, two companies in the sample data are selected for detailed analysis. Finally, research conclusion and corresponding talent management strategies are presented. The results show that the cumulative contribution value of employees is 87.496%. The cumulative contribution value of human capital is 70.322%. The contribution value of cumulative innovation performance is 61.658%. The cumulative contribution value of R&D investment is 45.306%. The coefficient for the overall sample size is 0.509. The employee quality coefficient is 0.452. The correlation coefficient for educational attainment is 0.598. The high-tech service industry has the highest correlation coefficient at 0.504. The auto industry has the highest coefficient at 0.669. The experimental research has drawn the following conclusion: (1) Talents positively affect enterprise innovation performance; (2) Research and Development (R&D) investment has a positive correlation with enterprise innovation performance; (3) R&D investment has a positive correlation with talents. Through experimental research, the education level of employees is measured by academic qualifications, but the essence of academic qualification measurement is the level of knowledge and skills that employees have. In summary, the study can extend the strategic analysis of the cultivation of innovative talents and play a valuable auxiliary role in cultivating innovative talents.

Background and aim: Real-world data on the effectiveness and safety of treatment with the direct-acting antiviral agent-based regimen are limited on the Chinese mainland. The aim of this study was to conduct a multicenter, prospective, real-world study of ombitasvir/paritaprevir/ritonavir (OBT/PTV/r) combined with dasabuvir (DSV) in hepatitis C virus (HCV) genotype 1b-infected non-cirrhotic or compensated cirrhotic Chinese adult patients. Materials and methods: Genotype 1b-infected patients were enrolled at eight sites in China. Patients received 25/150/100 mg of OBT/PTV/r once daily combined with 250 mg of DSV twice daily for 8 weeks or 12 weeks. Sustained virological response at 12 weeks post-treatment (SVR12) and the incidence of adverse events were assessed. We have also evaluated the effect of intensive questioning of patients who were overdue for SVR12 testing. Intention-to-treat (ITT) and modified ITT (mITT) populations were used in the analysis. Results: One hundred forty patients were included, among whom 90.0% (126/140) were newly diagnosed, 9.3% (13/140) had compensated cirrhosis, 92.9% (130/140) received 12 weeks of treatment, and 7.1% (10/140) received 8 weeks of treatment. In the mITT population, the virological response rate at week 4 was 96.4% (108/112), and at the end of treatment was 100% (102/102). Among these patients, 139 patients completed 12 weeks of treatment, and 73 patients were followed-up. All followed-up patients achieved SVR12. There was no adverse event-related discontinuation. Serious adverse events during treatment were reported in two (1.4%) patients, and none were considered to be drug-related. Sixty-six (47.1%) patients did not return to receive the HCV RNA test at 12 weeks post-treatment. Conclusions: The rate of SVR12 was consistent with Phase III clinical studies. OBT/PTV/r combined with DSV showed effectiveness in Chinese adult patients, and both tolerability and safety profile were favorable. However, patient compliance should be further improved in the real world.

Abstract Introduction In December, 2019, an outbreak of the coronavirus disease 2019 (COVID-19), which was caused by a novel coronavirus, started in Wuhan, China. So far, there is limited clinical evidence on the effect of corticosteroid therapy for this disease. This study aims to investigate the association between corticosteroid therapy and the duration of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) clearance among patients with mild COVID-19. Methods Patients with mild COVID-19 were enrolled from two medical centers in China between January 13, 2020 and February 29, 2020. Baseline characteristics and durations of RNA clearance were compared between the corticosteroid and non-corticosteroid therapy groups. The independent effects of corticosteroid therapy on the duration of RNA clearance were estimated by generalized linear models. Results Of 82 patients with a mild infection, 40 patients were male (48.8%), with a median age of 49 years (interquartile range, IQR 36–61). Among those patients, 36 patients (43.9%) received corticosteroid therapy. The adjusted multivariate models showed that the effects of corticosteroids were non-significant on the durations of onset to first RNA clearance [β 2.48, 95% CI (95% confidence interval) − 0.42 to 5.38, P = 0.0926] and to persistent RNA clearance (β 1.54, 95% CI − 1.41 to 4.48, P = 0.3016), and durations of therapy to first RNA clearance (β 2.16, 95% CI − 0.56 to 4.89, P = 0.1184) and to persistent RNA clearance (β 1.22, 95% CI − 1.52 to 3.95, P = 0.3787). Conclusions Corticosteroid therapy in patients with mild COVID-19 was not associated with the duration of SARS-CoV-2 clearance, suggesting that the use of corticosteroids may not be beneficial for patients with mild COVID-19 and should be prudently recommended in clinical practice. However, further studies are needed to verify the findings.

The early detection and accurate histopathological diagnosis of gastric cancer are essential factors that can help increase the chances of successful treatment. Here, the authors report on a digital pathology tool achieving high performance on a real world test dataset and show that the system can aid pathologists in improving diagnostic accuracy.

Purpose: Perioperative glucocorticoids have the potential to increase the risk of tumor metastasis. However, the relationship between perioperative glucocorticoids and oncologic outcomes remains controversial. The present study was undertaken to evaluate the association of perioperative glucocorticoids with clinicopathologic outcomes following radical cystectomy (RC). Materials and Methods: We screened and included 185 patients who underwent radical surgery for bladder cancer in our center between 2009 and 2018. The Kaplan–Meier method was applied, and a log-rank test was used to estimate differences in metastasis-free survival (MFS) and overall survival (OS) between the groups. Multivariate Cox proportional hazards regression models were used to analyze any association of glucocorticoids with clinical outcomes. Results: A total of 76 (41.1%) patients received perioperative glucocorticoids. Median postoperative follow-up was 2.0 years. Kaplan–Meier survival curve indicated that the glucocorticoids group was significantly associated with increased distant MFS (p=0.008) but not with OS. In the multivariate analysis, no significant differences were observed for MFS between the groups. Interestingly, when the variable of blood transfusion was excluded from the multivariate analysis model, we found that patients receiving glucocorticoids were independently associated with worse MFS (hazard ratio, 1.790; p=0.030). Furthermore, the partial correlation analysis showed a significant positive correlation between perioperative glucocorticoids and blood transfusion (r=0.604, p

Abstract Background Ovarian cancer is one of the most common gynecologic cancers and has high mortality rate due to the lack of early diagnosis method and efficient therapeutic agents. circCELSR1 is up-regulated in ovarian cancer, but its role and mechanisms in ovarian cancer are unclear. Methods Gene expression of circCELSR1, miR-598 and BRD4 in ovarian cells was examined by qRT-PCR. Protein level was determined by Western blotting. Bioinformatic analysis and luciferase assay determined the molecular binding among circCELSR1, miR-598 and BRD4 3′ UTR. Cell proliferation, migration, invasion and apoptosis were determined by colony formation, wound healing assay, transwell assay and flow cytometry analysis, respectively. An abdominal cavity metastasis nude mice model was used to determine the in vivo function of circCELSR1. Results circCELSR1 and BRD4 were promoted, but miR-598 was suppressed in various ovarian cancer cells. circCELSR1 bound to miR-598 and promoted expression of its downstream target BRD4. Knockdown of circCELSR1 suppressed proliferation, migration, invasion and epithelial-mesenchymal transition (EMT), but promoted apoptosis in ovarian cancer cells, and these effects were reversed by miR-598 inhibition or BRD4 overexpression. circCELSR1 inhibition decreased the expression of BRD4 and its downstream proliferation/migration related genes by targeting miR-598. Furthermore, knockdown of circCELSR1 suppressed ovarian cancer growth and metastasis in nude mice. Conclusion Knockdown of circCELSR1 inhibited BRD4-mediated proliferation/migration related signaling via sponging miR-598, thereby repressing ovarian cancer progression. This study provides a new regulatory mechanism of ovarian cancer may facilitate the development of therapeutic agents for ovarian cancer.

Abstract Background Sarcopenia is a skeletal muscle disorder. Recent studies have shown an association between muscle health and suicide. However, there have been no previous studies on the relationship between suicide risk severity and sarcopenia in major depressive disorder (MDD). This study aimed to explore the association between suicide risk severity and sarcopenia in non-elderly Chinese inpatients with MDD. Methods The first-episode drug-naïve MDD inpatients aged 20–59 years with the 24-item Hamilton Rating Scale for Depression (HAMD-24) scores of >20 were included, who were then classified into low, intermediate, high and very high suicide risk groups according to the Nurses’ Global Assessment of Suicide Risk (NGASR). The HAMD-24, the Hamilton Rating Scale for Anxiety (HAMA) and the SARC-F questionnaire were used to assess depression severity, anxiety severity and sarcopenia, respectively. The plasma levels of cortisol and adrenocorticotropic hormone (ACTH) were measured. Results A total of 192 MDD inpatients (122 females, 70 males; aged 39.3 ± 11.7 years) were included, with 12.5% meeting criteria for sarcopenia. There were significant differences in gender, HAMD score and prevalence of sarcopenia among the suicide risk groups. Adjusted ordinal regression analysis showed that sarcopenia was significantly associated with more severe suicide risk (OR = 2.39, 95%CI 1.02–5.58, p = 0.044) independent of depression severity. Conclusions This study revealed that sarcopenia was significantly associated with higher suicide risk in non-elderly Chinese MDD inpatients after adjustment for depression severity. Intervention of sarcopenia might be effective in reducing the risk of suicide in non-elderly MDD patients.

Abstract Background Clear cell tumors of the lung (CCTLs) are rare and mostly benign pulmonary neoplasms arising from perivascular epithelioid cells. Only approximately 100 cases have been reported, and half of them were in China. Limited details about CCTLs often cause diagnostic or therapeutic problems. Case presentation We describe a case of a 28-year-old woman with multiple gradually replicating and enlarging nodules in the left lower lobe. The patient underwent fine-needle aspiration biopsy and was diagnosed with CCTL. A left lower lobectomy and mediastinal lymph node dissection were performed. The gradual changes in size (1.4 cm to 2.8 cm) and quantity (10 to 49) of the CCTLs in this case were the biggest differences from previously reported cases. Conclusions CCTLs are very uncommon and mostly benign PEComatous tumors with no specific morphologic features. We present a case of CCTL with multiplicity and rapid growth, which may indicate its aggressive nature. The accumulation of similar cases will help clarify the exact nature and improve our understanding of the disease.

Background and aims: To investigate the safety and efficacy of direct-acting antiviral (DAA) regimens in a cohort of Chinese patients with chronic hepatitis C virus (HCV) infection. Methods: A total of 222 adult Chinese patients were enrolled and treated via DAA regimens in accordance with HCV management guidelines. Treatment responses were evaluated 4 weeks after treatment, at the end of treatment (EOT) and 12 weeks post-treatment. Virological responses, biochemical responses, model for end-stage liver disease (MELD) and Child-Pugh (CP) scores were recorded. Results: A total of 218 patients (98.2%) achieved sustained virological response 12 weeks post-treatment and 4 patients relapsed. The combined number of rapid virological responses for all six regimens was 170/222 (76.6%), and 221/222 (99.6%) had achieved virological responses by the end of treatment. In decompensated cirrhosis patients the baseline mean CP score was 6.8 ± 1.3 and the mean MELD score was 10.1 ± 3.3. Compared with the mean CP score at baseline, the mean score is significantly lower at the end of treatment (5.7 ± 1.3) and 12 weeks post-treatment (5.6 ± 1.0). Estimated glomerular filtration rates did not differ significantly from baseline during the treatment or 12 weeks post-treatment. The incidence of adverse events in patients with chronic hepatitis C and compensated cirrhosis was 42/172 (24.4%), and in patients with decompensated cirrhosis it was 8/22 (36.4%). The most frequently reported adverse events were elevated indirect bilirubin, fatigue and rash. There were no cases of serious adverse events, death or treatment discontinuation because of adverse events. Conclusion: DAA regimens were highly effective and well tolerated irrespective of HCV genotype, cirrhosis, liver or kidney transplantation, hepatocellular carcinoma, HCV/hepatitis B virus co-infection, or renal failure.

The motor system controls muscle movement through lower motor neurons in the spinal cord and brainstem. Lower motor neurons are efferent neurons in the central nervous system (CNS) characterized by axonal projections that reach specific targets in the periphery. Lower motor neuron lesions result in the denervation and dysfunction of peripheral skeletal muscle. Great progress has been made to develop therapeutic strategies to transduce lower motor neurons with genes. However, the widespread distribution of lower motor neurons makes their specific, extensive, and efficient transduction a challenge. In this study, we demonstrated that, compared to the other tested recombinant adeno-associated virus (rAAV) serotypes, rAAV2-retro mediated the most efficient retrograde transduction of lower motor neurons in the spinal cord following intramuscular injection in neonatal mice. A single injection of rAAV2-retro in a single muscle enabled the efficient and extensive transduction of lower motor neurons in the spinal cord and brainstem rather than transducing only the lower motor neurons connected to the injected muscle. rAAV2-retro achieved the extensive transduction of lower motor neurons by the cerebrospinal fluid pathway. Our work suggests that gene delivery via the intramuscular injection of rAAV2-retro represents a promising tool in the development of gene therapy strategies for motor neuron diseases.

AIM: To analyze the curative effect and safety of modified dacryocystorhinostomy with simple anterior flap anastomosis in the treatment of chronic dacryocystitis.METHODS: A total of 99 patients(113 affected eyes)with chronic dacryocystitis who underwent dacryocystorhinostomy in the hospital between March 2016 and July 2018 were enrolled in the retrospective study. They were divided into the traditional group(traditional dacryocystorhinostomy, 46 cases, 52 affected eyes)and the modified group(modified surgery with simple anterior flap anastomosis, 53 cases, 61 affected eyes)according to the surgical procedures. The surgical results, rates of granulation tissue formation around the anastomotic stoma at different time after surgery, rates of nasal mucosal epithelialization, size of the anastomotic stoma, the occurrence of surgical complications and the recurrence rate during 1a of follow-up were compared between the two groups.RESULTS: The grade of curative effect in the modified group was better than the traditional group(75.0% vs 95.1%)during 6mo of follow-up(PPvs 39.1%, Pvs 11.34±3.52mm2, Pvs 11.34±3.52mm2,PPCONCLUSION: The cure rate of patients undergoing modified dacryocystorhinostomy with simple anterior flap anastomosis is higher than those undergoing traditional surgery. The former can promote nasal mucosal epithelialization, maintain the size of anastomotic stoma and prevent the formation of surrounding granulation tissue. It is safe and effective, with few complications and low recurrence rate.

Objectives: As a global pandemic is inevitable, real-time monitoring of transmission is vital for containing the spread of COVID-19. The main objective of this study was to report the real-time effective reproduction numbers (R(t)) and case fatality rates (CFR) in Europe. Methods: Data for this study were obtained mainly from the World Health Organization website, up to March 9, 2020. R(t) were estimated by exponential growth rate (EG) and time-dependent (TD) methods. ‘R0’ package in R was employed to estimate R(t) by fitting the existing epidemic curve. Both the naïve CFR (nCFR) and adjusted CFR (aCFR) were estimated. Results: With the EG method, R(t) was 3.27 (95% confidence interval (CI) 3.17–3.38) for Italy, 6.32 (95% CI 5.72–6.99) for France, 6.07 (95% CI 5.51–6.69) for Germany, and 5.08 (95% CI 4.51–5.74) for Spain. With the TD method, the R value for March 9 was 3.10 (95% CI 2.21–4.11) for Italy, 6.56 (95% CI 2.04–12.26) for France, 4.43 (95% CI 1.83–7.92) for Germany, and 3.95 (95% CI 0–10.19) for Spain. Conclusions: This study provides important findings on the early outbreak of COVID-19 in Europe. Due to the recent rapid increase in new cases of COVID-19, real-time monitoring of the transmissibility and mortality in Spain and France is a priority.

Since early January 2020, after the outbreak of coronavirus infection in Wuhan, China, ≈365 confirmed cases have been reported in Shenzhen, China. The mode of community and intrafamily transmission is threatening residents in Shenzhen. Strategies to strengthen prevention and interruption of these transmissions should be urgently addressed.

Abstract Aims/Introduction Elevated serum cancer antigen 19‐9 (CA19‐9) levels have been found in diabetes patients in most observational studies; however, whether there is a causal association between CA19‐9 and diabetes mellitus is unclear. Materials and Methods Our study was carried out based on the Dongfeng‐Tongji cohort comprising 27,009 individuals. We first investigated the associations between serum CA19‐9 levels and incident diabetes mellitus risk in a prospective cohort study (12,700 individuals). Then, we explored the potential causal relationship between CA19‐9 and diabetes mellitus risk in a cross‐sectional study (3,349 diabetes mellitus patients and 8,341 controls) using Mendelian randomization analysis. A weighted genetic risk score was calculated by adding the CA19‐9 increasing alleles in five single‐nucleotide polymorphisms (rs17271883, rs3760776 and rs3760775 in FUT6, rs11880333 in CA11, rs265548 in B3GNT3, and rs1047781 in FUT2), which were identified in a previous genome‐wide association study on serum CA19‐9 levels. Results In the prospective study, a total of 1,004 incident diabetes mellitus patients were diagnosed during a mean 4.54‐year follow‐up period. Elevated serum CA19‐9 level was associated with a higher incident diabetes risk after adjustment for confounders, with a hazard ratio of 1.20 (95% confidence interval 1.11–1.30) per standard deviation (12.17 U/mL) CA19‐9 increase. Using the genetic score to estimate the unconfounded effect, we did not find a causal association of CA19‐9 with diabetes risk (odds ratio per weighted CA19‐9‐increasing allele: 0.99, 95% confidence interval 0.94–1.04; P = 0.61). Conclusions The present study did not support a causal association of serum CA19‐9 with diabetes risk. CA19‐9 might be a potential biomarker of incident diabetes mellitus risk.

Mosquito-derived xanthurenic acid (XA) is a trigger for gametogenesis of Plasmodium parasites. Here the authors show that the putative amino acid transporter GEP1 is required for XA-stimulated gametogenesis in Plasmodium yoelii and that it interacts with guanylyl cyclase α (GCα), a cGMP synthesizing enzyme in gametocytes.

Abstract Background The novel coronavirus disease 2019 (COVID-19) outbreak started in Wuhan, Hubei, China since Dec 2019 and cases of infection have been continuously reported in various countries. It is now clear that the SARS-COV-2 coronavirus is transmissible from human to human. Nucleic acid detection is considered as the gold standard for the diagnosis of COVID-19. In this case report, we describe our experience in detection of SARS-COV-2 from a confirmed patient using nucleic acid test of bronchoalveolar-lavage fluid (BALF) samples but not nasopharyngeal swabs. Case presentation We present a case of severely ill SARS-COV-2 infected 46-year-old man with fever, coughing and chest tightness. We performed viral detection using his BALF samples and imaging method (CT) for confirmation. The patient received combination of interferonalfa-1b and ribavirin, lopinavir and ritonavir for antiviral treatment at different stages. Other medication was also given to him in combination for anti-inflammation, intestinal microbial regulation, phlegm elimination, liver protection and pulmonary fibrosis prevention purposes. We provided oxygen supply to him using BIPAP ventilator and high-flow humidification oxygen therapy instrument to facilitate respiration. The patient was cured and discharged. Conclusion This case report described an effective supportive medication scheme to treat SARS-COV-2 infected patient and emphasized the necessity of detection of the viral genome using BALF samples and its significance in the diagnosis and prognosis of the disease.

Background:Myocardial impairment is a major complication and an important prognostic predictor of sepsis. Therefore, early and accurate diagnosis as well as timely management of septic cardiomyopathy is critical to achieve favorable outcomes.Aims:To investigate the risk factors of septic cardiomyopathy.Study Design:Cross-sectional study.Methods:This study performed between May 2016 and June 2018 recruited 93 septic patients from the intensive care unit. All patients received standardized treatments. Septic patients were divided into two groups: non cardiomyopathy (n=45) and septic cardiomyopathy group (n=48). Blood samples were collected and transthoracic echocardiography was performed within 24 hours of intensive care unit admission. Septic patients with one ultrasound abnormality but no history of heart disease were diagnosed as having septic cardiomyopathy. Plasma histones, cardiac troponin I, and N-terminal pro-brain natriuretic peptide were measured using ELISA. Sequential Organ Failure Assessment scores, vasopressor use, and the outcomes of intensive care unit stay were analyzed. Spearman rank analysis was used to determine the correlation between plasma histone H4 and other parameters. Binary logistic regression and receiver operating characteristic curve analysis were used to determine the risk factors for septic cardiomyopathy.Results:Compared with the non-cardiomyopathy group, the septic cardiomyopathy group had significantly higher plasma H4 and cardiac troponin I levels, a higher Sequential Organ Failure Assessment score, more frequent vasopressor use, and a higher mortality rate (p

ABSTRACTManaging recovered COVID-19 patients with recurrent-positive SARS-CoV-2 RNA test results is challenging. We performed a population-based observational study to characterize the viral RNA level and serum antibody responses in recurrent-positive patients and evaluate their viral transmission risk. Of 479 recovered COVID-19 patients, 93 (19%) recurrent-positive patients were identified, characterized by younger age, with a median discharge-to-recurrent-positive length of 8 days. After readmission, recurrent-positive patients exhibited mild (28%) or absent (72%) symptoms, with no disease progression. The viral RNA level in recurrent-positive patients ranged from 1.8 to 5.7 log10 copies/mL (median: 3.2), which was significantly lower than the corresponding values at disease onset. There are generally no significant differences in antibody levels between recurrent-positive and non-recurrent-positive patients, or in recurrent-positive patients over time (before, during, or after recurrent-positive detection). Virus isolation of nine representative specimens returned negative results. Whole genome sequencing of six specimens yielded only genomic fragments. 96 close contacts and 1,200 candidate contacts of 23 recurrent-positive patients showed no clinical symptoms; their viral RNA (1,296/1,296) and antibody (20/20) tests were negative. After full recovery (no longer/never recurrent-positive), 60% (98/162) patients had neutralizing antibody titers of ≥1:32. Our findings suggested that an intermittent, non-stable excretion of low-level viral RNA may result in recurrent-positive occurrence, rather than re-infection. Recurrent-positive patients pose a low transmission risk, a relatively relaxed management of recovered COVID-19 patients is recommended.

Abstract Background Circular RNAs (circRNAs) represent a class of non-coding RNAs (ncRNAs) which are widely expressed in mammals and tissue-specific, of which some could act as critical regulators in the atherogenesis of cerebrovascular disease. However, the underlying mechanisms by which circRNA regulates the ectopic phenotype of endothelial cells (ECs) in atherosclerosis remain largely elusive. Methods CCK-8, transwell, wound healing and Matrigel assays were used to assess cell viability, migration and tube formation. QRT-qPCR and Immunoblotting were used to examine targeted gene expression in different groups. The binding sites of miR-370-3p (miR-370) with TGFβR2 or hsa_circ_0003204 (circ_0003204) were predicted using a series of bioinformatic tools, and validated using dual luciferase assay and RNA immunoprecipitation (RIP) assay. The localization of circ_0003204 and miR-370 in ECs were investigated by fluorescence in situ hybridization (FISH). Gene function and pathways were enriched through Metascape and gene set enrichment analysis (GSEA). The association of circ_0003204 and miR-370 in extracellular vesicles (EVs) with clinical characteristics of patients were investigated using multiple statistical analysis. Results Circ_0003204, mainly located in the cytoplasm of human aorta endothelial cells (HAECs), was upregulated in the ox-LDL-induced HAECs. Functionally, the ectopic expression of circ_0003204 inhibited proliferation, migration and tube formation of HAECs exposed to ox-LDL. Mechanically, circ_0003204 could promote protein expression of TGFβR2 and its downstream phosph-SMAD3 through sponging miR-370, and miR-370 targeted the 3′ untranslated region (UTR) of TGFβR2. Furthermore, the expression of circ_0003204 in plasma EVs was upregulated in the patients with cerebral atherosclerosis, and represented a potential biomarker for diangnosis and prognosis of cerebrovascular atherogenesis. Conclusions Circ_0003204 could act as a novel stimulator for ectopic endothelial inactivation in atherosclerosis and a potential biomarker for cerebral atherosclerosis.

Abstract Background Mycoplasma pneumoniae is one of the most common causative pathogens of community-acquired pneumonia (CAP), accounting for as many as 30–50% of CAP during peak years. An early and rapid diagnostic method is key for guiding clinicians in their choice of antibiotics. Methods The recombinase-aided amplification (RAA) assay is a recently developed, rapid detection method that has been used for the detection of several pathogens. The assays were performed in a one-step single tube reaction at 39° Celsius within 15–30 min. In this study, we established an RAA assay for M. pneumoniae using clinical specimens for validation and commercial real-time PCR as the reference method. Results The analytical sensitivity of the RAA assay was 2.23 copies per reaction, and no cross-reactions with any of the other 15 related respiratory bacterial pathogens were observed. Compared with the commercial real-time PCR assay used when testing 311 respiratory specimens, the RAA assay obtained 100% sensitivity and 100% specificity with a kappa value of 1. Conclusions These results demonstrate that the proposed RAA assay will be of benefit as a faster, sensitive, and specific alternative tool for the detection of M. pneumoniae.

Indoor mobile robots normally cannot capture the whole information of a scene by a single frame of perceptive data due to the limited sensor scope. The category of the current scene may be misjudged by robotics due to incomplete scene information, which leads to operation error. To address this problem, we propose an approach that leverages conditional random fields (CRFs) to fuse multiframe RGB and depth (RGB-D) visual data corresponding to the same scene. This method takes full advantage of prior knowledge that object categories significantly relate to the scene attributes. As a new image arrives, we incrementally integrate the current object detection results to update scene understanding by identifying duplicate objects between images, ranking available objects in terms of their relevance to the scene, and fusing new information with the existing CRF. With this approach, scene classification can be solved with higher precision based on multiview images than on single image frames sampled in the same places. Additionally, a configuration map of a scene is incrementally built into the above framework. The map includes identities of the recognized objects and various relations between them. This kind of map would not only benefit common robotic tasks but also offer a novel channel for human-robot interaction. We test the efficiency of our method on image sequences extracted from the NYU v2 dataset. The results show that our approach achieves the best performance against state-of-the-art baselines.

Performance degradation assessment (PDA) is of great significance to ensure safety and availability of mechanical equipment. As an important issue of PDA, the robustness of the trained model directly affects the assessment efficiency and restricts its application in practice. This paper proposes a robust modeling approach based on Student's t-hidden Markov model (Student's t-HMM) and nuisance attribute projection (NAP). NAP can remove nuisance attributes caused by individual differences from the feature space. Student's t-HMM utilizes the finite Student's t-mixture models (SMMs) to describe the observation emission densities associated with each hidden state, which can be more tolerant towards outliers than conventional HMMs. Based on these two techniques, the proposed method is supposed to be more robust and can assess the performance degradation process of new objects based on data of tested objects. The superiority of the proposed approach is evaluated using the vibration data from the accelerated life tests of bearings and the public XJTU-SY Bearing Datasets. The results demonstrate the robustness and effectiveness of the proposed approach for PDA modeling of rolling element bearings.

Considering that large quantities of soil hyperspectral data include the redundancy and overlap of spectral information, the technology of selecting feature wavelength can effectively solve these problems, and improve the accuracy and stability of the soil organic matter (SOM) content retrieval model. Traditional methods of wavelength selection mainly attempt to establish the empirical relationship between reflectance and SOM contents, and the performance is directly related to the quality and representativeness of the “training data”. This study first distinguished the sensitive wavelength interval of SOM through the sensitivity analysis (SA) of the SOM to soil reflectance in radiative transfer model. Then sensitive wavelength points of SOM were ascertained using the successive projection algorithm (SPA): 468, 476, 496, 599, 775 and 900nm. Results show that SOM content can be estimated with high accuracy (root-mean-square error of prediction (RMSEP) 2) > 82.9%) by adopting the selected six wavelengths. Especially at 599nm, the accuracy of SOM content estimation is the highest (RMSEP: 0.176%, R2: 90.4%). Compared with traditional empirical wavelength selection methods, the wavelength selection based on the SA-SPA with the SOM radiative transfer model improves the generalizability and accuracy of the result. The research provides theoretical basis and technical support for the remote sensing retrieval of SOM, the development of rapid spectral instruments, and the bands setting of sensor instrument.

In order to recognize different materials from passive polarimetric measurements specifically, a model that can describe the distribution of polarization energy scattered from the target surface is needed for estimating the parameters of interest (complex refractive index n, k and surface roughness σ) of targets. This paper presents a new method for targets parameters estimation. The presented method modifies the degree of linear polarization (DOLP) model by introducing the Lorentz-Drude dispersion constants which do not vary with wavelength as well as the diffuse component of reflection related to the surface roughness to the DOLP equation. This solves the problem of difficulty and inaccuracy caused by multi-angle passive polarimetric measurements used by previous works and helps to improving the parameters estimation accuracy for rough targets. The Monte Carlo simulations result illustrate that the presented method is robust to Gaussian noise. Moreover, the experimental results of rough aluminium plate and rough copper plate validate the effectiveness of the presented model. The errors of estimated n are about 8% for aluminium plate and 9% for copper plate. The errors of estimated k are less than 4% for aluminium plate and no more than 5% for copper plate. The errors of estimated surface roughness σ are about 6.8% and about 6% for aluminium plate and copper plate respectively. The high estimation accuracy and less detection angle requirement achieved by the presented method are significant for material characterization in passive remote sensing application.

In tunable diode laser absorption spectroscopy (TDLAS), the wavelength modulation spectroscopy (WMS) is widely employed. However, when measuring the gas concentration with the second harmonic signal, errors will occur and the inversion accuracy will be reduced, because the change of the modulation depth will lead to the change of the second harmonic peak value, and the value of modulation depth cannot be calculated directly in the absence of gas component. To improve the inversion accuracy of WMS technology, we calibrate the modulation depth and take it as a parameter to the concentration inversion model. In this article, the relationship between the modulation depth and the valley spacing of the second harmonic is first derived, and used to calibrate the modulation depth in the measurement; then, an improved concentration inversion model is established by adding the calibrated modulation depth to the traditional model. Through simulations in Simulink and gas concentration measurement experiments with carbon monoxide (CO), the effectiveness of modulation depth calibration using valley spacing and the accuracy of the improved model are verified. The gas concentration measurement error of the improved model (relative error -5) is reduced by nearly one order of magnitude compared to the traditional model without calibration of the modulation depth (relative error -4). The correction method of modulation depth in this article does not need the priori information of the gas component, and the improved model produces a better determination of gas concentration immune to the variations of modulation depth, which is important for field measurements especially those with large environmental variations.

The vibration effect of subway train operation on the adjacent building structure has become one of the outstanding problems in the development of urban underground rail transit and the construction facilities along the line. The new technology of intelligent interconnection provides new ideas for the analysis of the impact of subway vibration, but the network edge side faces many challenges such as connecting massive heterogeneous devices and real-time business. Therefore, in this article, based on the needs of actual projects, on the basis of edge computing technology, through the field measurement and numerical simulation methods, the typical subway adjacent building structure is affected by the vibration of subway train operation. Edge computing solves the urgent need to realize the function of cloud computing at the edge equipment of massive subway networks, and provides active support for the analysis of the vibration impact of subway train operations on adjacent building structures. Practical case analysis and vibration impact assessment illustrate the superiority of the realization of edge analysis-based metro operation on the vibration analysis of buildings along the line. This method can provide scientific reference and basis for the exhibition of modern subway technology.

BackgroundOver the recent years, machine learning methods have been increasingly explored in cancer prognosis because of the appearance of improved machine learning algorithms. These algorithms can use censored data for modeling, such as support vector machines for survival analysis and random survival forest (RSF). However, it is still debated whether traditional (Cox proportional hazard regression) or machine learning-based prognostic models have better predictive performance. ObjectiveThis study aimed to compare the performance of breast cancer prognostic prediction models based on machine learning and Cox regression. MethodsThis retrospective cohort study included all patients diagnosed with breast cancer and subsequently hospitalized in Fudan University Shanghai Cancer Center between January 1, 2008, and December 31, 2016. After all exclusions, a total of 22,176 cases with 21 features were eligible for model development. The data set was randomly split into a training set (15,523 cases, 70%) and a test set (6653 cases, 30%) for developing 4 models and predicting the overall survival of patients diagnosed with breast cancer. The discriminative ability of models was evaluated by the concordance index (C-index), the time-dependent area under the curve, and D-index; the calibration ability of models was evaluated by the Brier score. ResultsThe RSF model revealed the best discriminative performance among the 4 models with 3-year, 5-year, and 10-year time-dependent area under the curve of 0.857, 0.838, and 0.781, a D-index of 7.643 (95% CI 6.542, 8.930) and a C-index of 0.827 (95% CI 0.809, 0.845). The statistical difference of the C-index was tested, and the RSF model significantly outperformed the Cox-EN (elastic net) model (C-index 0.816, 95% CI 0.796, 0.836; P=.01), the Cox model (C-index 0.814, 95% CI 0.794, 0.835; P=.003), and the support vector machine model (C-index 0.812, 95% CI 0.793, 0.832; P

BackgroundSelf-medication of antibiotics is common in China, whereas the self-medication of other medicines is still unknown, especially for the younger children who are vulnerable to adverse drug events. The aim of this study was to estimate the prevalence of self-medication reported by parents among children under age 12 in China.MethodsA national cross-sectional survey was conducted among parents of children under age 12 in China by using a self-administered online questionnaire. Parents were asked whether they have self-medicated their children in the past 12 months. Logistic regression analysis was performed to access the risk factors of self-medication.ResultsEligible questionnaires were obtained from 4,608 parents. The majority of respondents were mothers aged between 30 and 39 years old who held a college degree. A total of 1,116 (or 24.21%) respondents reported self-medication in the previous year. In the logistic regression model, parents with graduate degrees were less likely to self-medicate their children [Adjusted OR (AOR) = 0.436; 95% CI = 0.296–0.641]. The odds of self-medication were associated with being a father, living in Northern China, having a child at age 6–11, even though these did not reach statistical significance.ConclusionsOur findings indicate that self-medication are common in children under age 12, highlighting the drug safety issue in China. It seems that the educational level is the risk factors of self-medication. More targeted intervention and educational program should be implemented to improve drug safety.

This paper assesses the impact of emotional arousal on learning through a virtual reality video of geography immersion learning. Validity was measured with traditional questionnaire data and using electroencephalography (EEG). Twenty-four human subjects were recruited and presented with eight geography immersive learning videos with different affective tendencies. EEG data of the subjects were collected while they were watching the videos. After the video watching, subjects were requested to fill in an emotion scale, a learning motivation scale, and a mind flow experience. The results of the study show that VR video learning materials can well induce the positive and negative emotions of the subjects. Compared with negative emotions, the alpha band power in the frontal lobe of the brain, beta and gamma bands in the temporal lobe region is significantly higher under positive emotions. In addition, the results of the subjective scales indicate that subjects have stronger intrinsic motivations and better flow experiences under positive emotions. However, there was no significant difference for the immersion under positive and negative emotions. Our findings demonstrate the usability of teaching virtual reality situational geography stories and the broad value of using this teaching method for future instruction.

Gastric cancer is one of the most frequent causes of cancer-related deaths worldwide. Gastric atrophy (GA) and gastric intestinal metaplasia (IM) of the mucosa of the stomach have been found to increase the risk of gastric cancer and are considered precancerous lesions. Therefore, the early detection of GA and IM may have a valuable role in histopathological risk assessment. However, GA and IM are difficult to confirm endoscopically and, following the Sydney protocol, their diagnosis depends on the analysis of glandular morphology and on the identification of at least one well-defined goblet cell in a set of hematoxylin and eosin (H&E) -stained biopsy samples. To this end, the precise segmentation and classification of glands from the histological images plays an important role in the diagnostic confirmation of GA and IM. In this paper, we propose a digital pathology end-to-end workflow for gastric gland segmentation and classification for the analysis of gastric tissues. The proposed GAGL-VTNet, initially, extracts both global and local features combining multi-scale feature maps for the segmentation of glands and, subsequently, it adopts a vision transformer that exploits the visual dependences of the segmented glands towards their classification. For the analysis of gastric tissues, segmentation of mucosa is performed through an unsupervised model combining energy minimization and a U-Net model. Then, features of the segmented glands and mucosa are extracted and analyzed. To evaluate the efficiency of the proposed methodology we created the GAGL dataset consisting of 85 WSI, collected from 20 patients. The results demonstrate the existence of significant differences of the extracted features between normal, GA and IM cases. The proposed approach for gland and mucosa segmentation achieves an object dice score equal to 0.908 and 0.967 respectively, while for the classification of glands it achieves an F1 score equal to 0.94 showing great potential for the automated quantification and analysis of gastric biopsies.

In order to stabilize the output fluctuation of wind power generation, this paper applies control strategy to control the action of the battery energy storage system according to the stability target, and quickly makes up for the system demand. In this paper, the optimal scheduling of new energy power system with energy storage is studied. This model predictive control is introduced into a certain system and optimized by model predictive control strategy so that the combination can match the predetermined expectations. Then, the model predictive control strategy is used to improve the schedulability of the wind farm. The objective function is to minimize the amount of action, and the composite output can track the scheduling instructions. Considering the cost, the way of storage and operation cost is optimized, and the penalty cost of wind abandonment is also reduced. Through rolling optimization and feedback correction, the model predictive control is optimized and solved, and finally, the action instructions of the storage system are obtained so that the storage output can effectively calm the wind. Power makes the combination schedulable. The optimized wind power/energy storage output is equivalent to the benign and dispatchable power supply of the power grid.

Objective. The study aimed to evaluate the value of bedside echocardiography (TTE) and lower extremity blood vessels in diagnosis and prognosis of acute pulmonary embolism (APE). Methods. A retrospective study was performed on 53 patients with APE diagnosed by CT pulmonary angiography (CTPA) (systemic systolic blood pressure was >90 mmHg at time of consultation, and systemic systolic blood pressure decreased by

COVID-19 patients show heterogeneous and dynamic immune features which determine the clinical outcome. Here, we built a single-cell RNA sequencing (scRNA-seq) dataset for dissecting these complicated immune responses through a longitudinal survey of COVID-19 patients with various categories of outcomes. The data reveals a highly fluctuating peripheral immune landscape in severe COVID-19, whereas the one in asymptomatic/mild COVID-19 is relatively steady. Then, the perturbed immune landscape in peripheral blood returned to normal state in those recovered from severe COVID-19. Importantly, the imbalance of the excessively strong innate immune response and delayed adaptive immunity in the early stage of viral infection accelerates the progression of the disease, indicated by a transient strong IFN response and weak T/B-cell specific response. The proportion of abnormal monocytes appeared early and rose further throughout the severe disease. Our data indicate that a dynamic immune landscape is associated with the progression and recovery of severe COVID-19, and have provided multiple immune biomarkers for early warning of severe COVID-19.

Recent studies have reported that T-cell differentiation protein 2 (MAL2) is an important regulator in cancers. Here, we downloaded data from multiple databases to analyze MAL2 expression and function in pan-cancers, especially in ovarian cancer (OC). Gene Expression Profiling Interactive Analysis (GEPIA) databases was used to examine MAL2 expression in 13 types of cancer. Kaplan–Meier plotter database was used to analyze the overall survival rate of MAL2 in pan-cancers. The Catalog of Somatic Mutations in Cancer (COSMIC), cBioPortal, and UCSC databases were used to examine MAL2 mutation in human cancers. Metascape, STRING, and GeneMANIA websites were used to explore MAL2 function in OC. Furthermore, ggplot2 package and ROC package were performed to analyze hub gene expression and undertake receiver operating characteristic (ROC) analysis. Drug sensitivity of MAL2 in OC was examined by the GSCALite database. In order to verify the results from databases above, real-time quantitative polymerase chain reaction (qRT-PCR) and western blotting were conducted to detect the expression of MAL2 in OC cells. CRISPR/Cas9 system was used to knockout the MAL2 gene in the OC cell lines HO8910 and OVCAR3, using specific guide RNA targeting the exons of MAL2. Then, we performed proliferation, colony formation, migration, and invasion assays to investigate the impact of MAL2 in OC cell lines in vivo and in vitro. Epithelial-mesenchymal transition (EMT)-associated biomarkers were significantly altered in vitro via western blotting and qRT-PCR. Taken together, we observed that MAL2 was remarkably dysregulated in multiple cancers and was related to patient overall survival (OS), mutation, and drug sensitivity. Furthermore, experimental results showed that MAL2 deletion negatively regulated the proliferation, migration, invasion, and EMT of OC, indicating that MAL2 is a novel oncogene that can activate EMT, significantly promote both the proliferation and migration of OC in vitro and in vivo, and provide new clues for treatment strategies.

Streptococcus pneumoniae (S. pneumoniae) is a common major human pathogen associated with community-acquired pneumonia, septicemia, meningitis, and otitis media. It is difficult to isolate and identify S. pneumoniae form clinical samples. To evaluate a novel, rapid, sensitive, and specific loop-mediated isothermal amplification (LAMP) assay to detect S. pneumoniae pneumonia in children, we designed specific LAMP primers targeting lytA and psaA genes. We optimized the reaction time and reaction system, and evaluated its sensitivity and specificity of detection using real-time turbidity monitoring and visual observation. We also analyzed the molecular characteristics of the isolates obtained from the positive samples. The primer sets LytA-1 and PsaA-2 amplified the genes in the shortest times, and 63°C was confirmed as the optimum reaction temperature. The detection sensitivity of each reaction was 10 and 100 copies/μL with primer sets LytA-1 and PsaA-2, respectively. This LAMP assay showed no cross-reactivity with other 27 pathogens. To describe the availability of this method, we collected 748 clinical samples from children with pneumonia. Among them, 135 were confirmed to be S. pneumoniae positive by LAMP. The sensitivity was 100% (95% CI 96.4–100%), specificity 99.0% (95% CI 97.8–99.6%). Including them, 50 were co-infected with Mycoplasma pneumoniae. This LAMP assay detected S. pneumoniae in 1 h and the results can be identified with visual naked eyes. Thus, it will be a powerful tool for S. pneumoniae early diagnosis and effective antibiotic therapy.

As an essential microelement, the iron ion is involved in cell proliferation, metabolism, and differentiation. Iron metabolism plays a crucial role in the occurrence and development of colon adenocarcinoma (COAD). In this study, univariate and multivariate Cox regression, and least absolute shrinkage and selection operator analyses were conducted to construct the gene signature, based on a dataset from The Cancer Genome Atlas. We identified the prognostic value of two iron metabolism-related genes [SLC39A8 (encoding solute carrier family 39 member 8) and SLC48A1 (encoding solute carrier family 48 member 1)] in COAD. A nomogram model was established to predict the overall survival of patients with COAD. Functional analysis showed that the tumor microenvironment and immune cell infiltrate were different between the low risk and high risk subgroups. This study verified that the iron metabolism-related gene signature (SLC39A8 and SLC48A1) could be used as a prognostic biomarker for patients with COAD.

PurposeGrowing evidence shows that circulating tumor cells (CTCs) become more aggressive after the epithelial–mesenchymal transition (EMT), though the clinical significance of CTCs undergoing EMT in oligometastatic hormone-sensitive prostate cancer (omHSPC) patients has not yet been reported. Accordingly, the aim of this study was to detect the CTC level and investigate the clinical significance of mesenchymal CTCs in omHSPC patients who underwent cytoreductive radical prostatectomy (CRP).Materials and MethodsBlood samples were drawn from 54 omHSPC patients who underwent CRP. The CanPatrol CTC enrichment technique was applied to isolate and identify different phenotypes of CTCs, which were classified as epithelial (E-CTCs), mesenchymal (M-CTCs), or biphenotypic epithelial/mesenchymal (Bi-CTCs). Univariable and multivariable Cox regression analyses were employed to investigate potential prognostic factors for metastatic castration-resistant prostate cancer (mCRPC)-free survival and cancer-specific survival (CSS). The prognostic value of CTCs for CSS and mCRPC-free survival was assessed using time-dependent receiver operating characteristic (ROC) curves and Kaplan–Meier analysis.ResultsCTCs were detected in 51 of 54 patients (94%). E-CTC, M-CTC, and Bi-CTC detection rates were 56%, 67%, and 85%, respectively. A positive correlation was found between the M-CTC count and number of bone metastases (p = 0.012). Time-dependent ROC analysis showed that the M-CTC count had higher predictive power than E-CTC or Bi-CTC for mCRPC-free survival (3-year area under the curve [AUC] values: 0.64, 0.60, and 0.61) and CSS (3-year AUC: 0.86, 0.58, and 0.67). Additionally, time-dependent ROC analysis revealed total CTCs (T-CTCs) ≥5 and M-CTCs ≥2 to be the cutoff points with optimal specificity and sensitivity. Based on multivariable Cox regression, T-CTC and M-CTC counts were both independently associated with CSS and mCRPC-free survival (all p < 0.05), though E-CTCs and Bi-CTCs had no significant prognostic value (all p > 0.05). Patients with T-CTC ≥5 or M-CTC ≥2 had significantly worse mCRPC-free survival and CSS than those with T-CTC

PurposeThe therapeutic effect of extended pelvic lymph node dissection (PLND) in prostate cancer (PCa) patients is still controversial. The aim of this study was to identify the PCa patients who may benefit from extended PLND based on the 2012 Briganti nomogram.Materials and MethodsPCa patients who underwent radical prostatectomy (RP) plus PLND between 2010 and 2015 were identified from the Surveillance, Epidemiology, and End Results (SEER) database. The probability of lymph node invasion (LNI), determined using the 2012 Briganti nomogram, was used to stratify the patients. The endpoints were overall survival (OS) and cancer-specific survival (CSS). Propensity score matching (PSM) was performed to account for potential differences between patients with and without extended PLND. Univariable and multivariable Cox regression was used to analyze the association between the number of removed nodes (NRN) and survival. Kaplan–Meier analysis was performed to estimate OS and CSS. Extended PLND was defined as NRN >75th percentile.ResultsA total of 27,690 patients were included in the study. NRN was not an independent predictor of OS (p = 0.564). However, in patients with probability of LNI ≥37, multivariable analyses showed that increased NRN was associated with improved OS (hazard ratio [HR] = 0.963; p = 0.002). The 5-y OS rate was significantly higher for patients with NRN ≥12 than those with NRN 0.05).ConclusionExtensive PLND might be associated with improved survival in PCa patients with a high risk of LNI, which supports the use of extended PLND in highly selected PCa patients. The results need to be validated in prospective studies with long-term follow-up.

BackgroundAcute kidney injury (AKI) is a common complication of sepsis and is an independent risk factor for mortality. It is unclear whether different bacteria play different roles in the occurrence and development of sepsis-associated AKI (S-AKI). We observed the clinical characteristics and outcomes of patients that have types of bacterial infection, and different infections sites before the occurrence of AKI, respectively.MethodsData of patients who were diagnosed with sepsis and later developed AKI from 2008 to 2019 were retrieved from the MIMIC-IV 1.0 database. Patients were first divided into the two groups according to the bacterial culture results obtained prior to AKI occurrence: bacterial cultured positive (N = 1,785) and bacterial cultured negative (N = 8,777). Patients with bacteria culture positive were divided into culture bacteria Gram-positive (CGP, N = 1248) and Gram-negative (CGN, N = 537) groups.ResultsOverall, 1,785 patients were included in the present analysis. The patients in CGN group were older (70 vs. 66, p < 0.001), had lower body mass index (BMI) (27.0 vs. 28.4, p < 0.001), higher acute physiology III (APS III) score (63.0 vs. 58, p = 0.001), shorter time from positive microbial culture to diagnosis of AKI (2.94 vs. 3.16 days, p = 0.013) and longer intensive care unit (ICU) stay time (5.94 vs. 4.77 days, p < 0.001) compared with those in the CGP group (n = 1,248). In the culture gram-negative bacteria in patients with positive blood cultures (CGNb) group, the rate of vasopressors using (73.1 vs. 56.4%, P = 0.007), the Sequential Organ Failure Assessment (SOFA) score (10 vs. 9, p = 0.005), and the level of lactate (3.7 vs. 2.5, p = 0.001) were higher than those in the culture gram-positive bacteria in patients with positive blood cultures (CGPb) group. The time from positive microbial culture to the diagnosis of AKI was shorter (2.23 vs. 3 days, p = 0.001) in the CGNb group. However, there was no significant difference in the continuous renal replacement treatment (CRRT) application or short-term mortality rates between CGN and CGP groups.ConclusionThe Gram types of bacteria cultured prior to S-AKI occurrence was not related to AKI stage, CRRT application, and short-term mortality. Compared with the Gram-positive bacterial infections, Gram-negative bacterial infections take a shorter time to develop into AKI, and had a higher disease severity score.

Objective. To investigate the association of weight loss daily of term infants with hospitalization in the first week after birth. Methods. This prospective cohort study was conducted among 1865 infants from May 2020 to June 2021, born in the Department of Obstetrics, Kunshan’s First People’s Hospital Affiliated to Jiangsu University and Huai’an Maternal and Child Health Care Center. The infants’ weight was collected daily in the hospital, and the weight loss was calculated daily. According to the weight loss daily, the infants were divided into 3 groups. Group A: the weight loss per day was less than 2% of birth weight, and the total weight loss was less than 10%. Group B: the weight loss per day was between 2 and 4% of the birth weight, and the total weight loss was less than 10%. Group C: the weight loss per day was more than 4% of the birth weight, or the total weight was more than 10%. The infants in group C were monitored carefully in the hospital or Outpatient Department (OPD) daily. The primary outcome was the incidence of hospitalization. Results. Of the 1865 term infants enrolled, 1052 were completed on the 7th day (356 in group A, 513 in group B, and 183 in group C). There was no significant difference among the three groups of subjects in terms of infant data, including birth weight, gender, Apgar scores, and gestational age. The number of C-sections and primiparas was substantially higher in groups C and B than in group A. The incidence of hospitalization in group C was significantly higher than that in group A and group B (30.6%, 12.1%, and 12.5%, respectively). The incidence of exclusive breastfeeding in group C was significantly lower than that in group A and group B (28.4%, 41%, and 38.4%, respectively). There was no significant difference between group A and group B in the incidence of hospitalization and exclusive breastfeeding. Most of the hospitalization was because of hyperbilirubinemia, and in group C, there were 2 babies because of dehydration fever and 3 because of hypoglycemia. Conclusions. The neonates whose weight loss daily after birth was more than 4% of the total weight loss of more than 10% had higher hospitalization rates.

Background: Prolonged shedding/relapse of COVID-19 infection has been reported, particularly in patients who received anti-CD20 agents (eg. rituximab). However, cases of occult COVID-19, in which SARS-CoV-2 persistence in lung parenchyma is diagnosed despite clearance from nasopharyngeal (NP) specimens, are uncommon. Case summary: We describe two cases of occult COVID-19 in immunocompromised patients. Both patients had received rituximab previously. Both cases initially presented as ground-glass infiltrates on lung imaging; the diagnosis was originally not suspected due to repeated demonstration of negative SARS-CoV-2 from NP specimens, and alternative etiologies were originally considered. Persistence of SARS-CoV-2 in lung parenchyma, however, was demonstrated on bronchoalveolar lavage (BAL) specimens; additionally, isolation of viable SARS-CoV-2 virus and detection of SARS-CoV-2 nucleocapsid and spike-protein antigen in lung tissue on immunohistochemistry close to 3-months from primary infection strongly suggested ongoing viral persistence and replication as a driver of the lung parenchymal changes, which resolved after antiviral treatment. Discussion: Occult COVID-19 can be a cause of unexplained ground-glass infiltrates on lung imaging; negative NP samples do not rule out SARS-CoV-2 persistence and invasive sampling must be considered. The unsuspected presence of viable virus on BAL, however, highlights that procedurists perfoming aerosol-generating-procedures during an ongoing pandemic wave must also practise appropriate infection-prevention precautions to limit potential exposure.

The phase retardance of the optical system (PROS) is a crucial factor limiting the accuracy of the Stokes vector reconstruction for the channeled spectropolarimeter. The dependence on reference light with a specific angle of polarization (AOP) and the sensitivity to environmental disturbance brings challenges to the in-orbit calibration of PROS. In this work, we propose an instant calibration scheme with a simple program. A function with a monitoring role is constructed to precisely acquire a reference beam with a specific AOP. Combined with numerical analysis, high-precision calibration without the onboard calibrator is realized. The simulation and experiments prove the effectiveness and anti-interference characteristics of the scheme. Our research under the framework of fieldable channeled spectropolarimeter shows that the reconstruction accuracy of S2 and S3 in the whole wavenumber domain are 7.2 × 10−3 and 3.3 × 10−3, respectively. The highlight of the scheme is to simplify the calibration program and ensure that the PROS high-precision calibration is not disturbed by the orbital environment.