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Aldosterone-producing adenoma is a subtype of primary aldosteronism. Recent advancements in multi-omics research have led to significant progress in understanding primary aldosteronism at the genetic level. Among the various genes associated with the development of aldosterone-producing adenomas, the KCNJ5 (potassium inwardly rectifying channel, subfamily J, member 5) gene has received considerable attention due to its prevalence as the most common somatic mutation gene in primary aldosteronism. This paper aims to integrate the existing evidence on the involvement of KCNJ5 gene in the pathogenesis of aldosterone-producing adenomas, to enhance the understanding of the underlying mechanisms of aldosterone-producing adenomas from the perspective of genetics, and to provide novel insights for the clinical diagnosis and treatment of aldosterone-producing adenomas.

Background: Hypercoagulability emerges as a central pathological feature and clinical complication in nephrotic syndrome. Increased platelet activation and aggregability are closely related to hypercoagulability in nephrotic syndrome. Monocyte-platelet aggregates (MPAs) have been proposed to represent a robust biomarker of platelet activation. The aim of this study was to investigate levels of the circulating MPAs and MPAs with the different monocyte subsets to evaluate the association of MPAs with hypercoagulability in nephrotic syndrome., Methods: Thirty-two patients with nephrotic syndrome were enrolled. In addition, thirty-two healthy age and sex matched adult volunteers served as healthy controls. MPAs were identified by CD14 monocytes positive for CD41a platelets. The classical (CD14 + + CD16-, CM), the intermediate (CD14 + + CD16+, IM) and the non-classical (CD14 + CD16++, NCM) monocytes, as well as subset specific MPAs, were measured by flow cytometry., Results: Patients with nephrotic syndrome showed a higher percentage of circulating MPAs as compared with healthy controls (p < 0.001). The percentages of MPAs with CM, IM, and NCM were higher than those of healthy controls (p = 0.012, p < 0.001 and p < 0.001, respectively). Circulating MPAs showed correlations with hypoalbuminemia (r=-0.85; p < 0.001), hypercholesterolemia (r = 0.54; p < 0.001), fibrinogen (r = 0.70; p < 0.001) and D-dimer (r = 0.37; p = 0.003), but not with hypertriglyceridemia in nephrotic syndrome. The AUC for the prediction of hypercoagulability in nephrotic syndrome using MPAs was 0.79 (95% CI 0.68-0.90, p < 0.001). The sensitivity of MPAs in predicting hypercoagulability was 0.71, and the specificity was 0.78., Conclusion: Increased MPAs were correlated with hypercoagulability in nephrotic syndrome. MPAs may serve as a potential biomarker for thrombophilic or hypercoagulable state and provide novel insight into the mechanisms of anticoagulation in nephrotic syndrome., (© 2024. The Author(s).)

Chronic inflammatory reaction has been established as an important sign of the occurrence and development of diabetes mellitus (DM), accompanied by the production of a large number of inflammatory factors, thus aggravating the disease progression. As an important non-invasive intervention measure to inhibit inflammation, exercise plays a very important role in the amelioration of DM. NOD-like receptor protein 3 (NLRP3) inflammasome, a regulatory factor of inflammatory response, can induce a variety of inflammatory cascades and cell death, which are closely related to glucose uptake and dyslipidemia regulation. The development of DM can be postponed with exercise. Previous studies have reported the effects of NLRP3 inflammasome on DM, but the crucial role of exercise in this process remains unclear. Therefore, this paper reviews the research progress on the improving effects of exercise intervention on the symptoms of DM by mediating NLRP3 inflammasome, providing a novel theoretical foundation for understanding the prevention and treatment of DM through exercise.

Five undescribed sesquiterpenoid dimers, aucklandiolides A-E (1-5), one new sesquiterpenoid glycoside, β-cyclocostunolide-15-β-D-glucopyranoside (6), and seventeen known analogues (7-23) were isolated from the roots of Aucklandia costus. Their structures were elucidated by comprehensive HRESIMS and NMR spectroscopic data analysis, and their configurations were confirmed by the computational calculations of ECD and NMR chemical shifts. Aucklandiolides A and B are the first examples of dimeric sesquiterpenoids with a unique 6/6/6/5/6/6 ring system originated from a proposed Diels-Alder cycloaddition between two eudesmane sesquiterpenoids. Besides, compounds 9-11, 20, and 22 showed significant inhibition of nitric oxide production in LPS-stimulated RAW 264.7 cells at a concentration of 20 μM., Competing Interests: Declaration of Competing Interest The authors declare that there are no conflicts of interest., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Background: Chronic kidney disease (CKD) is usually considered an immune inflammatory disease. Interaction between platelets and monocytes is associated with immune inflammation. Cross-talk between platelets and monocytes is reflected by formation monocyte-platelet aggregates (MPAs). This study aims to test MPAs and MPAs with the different monocyte subsets to evaluate their association with disease severity in CKD., Methods: Forty-four hospitalized patients with CKD and twenty healthy volunteers were enrolled. The proportion of MPAs and MPAs with the different monocyte subsets were tested by flow cytometry., Results: The proportion of circulating MPAs in all patients with CKD were significantly higher than those of healthy controls (p<0.001). A higher proportion of MPAs with classical monocytes (CM) was found in CKD4-5 patients (p=0.007), while another higher proportion of MPAs with non-classical monocytes (NCM) was found CKD2-3 patients (p<0.001). The proportion of MPAs with intermediate monocytes (IM) in CKD 4-5 group was significantly higher in comparison to CKD2-3 group and healthy controls (p<0.001). Circulating MPAs were found to be correlated with serum creatinine (r=0.538, p<0.001) and eGFR (r=-0.864, p<0.001). The AUC for MPAs with IM was 0.942 (95% CI 0.890-0.994, p<0.001)., Conclusions: Study results highlight the interplay between platelets and inflammatory monocytes in CKD. There are alterations in circulating MPAs and MPAs with the different monocyte subsets in CKD patients compared to controls which change with CKD severity. The MPAs may have an important role in the development of CKD or as a predictive marker for monitoring disease severity., Competing Interests: Declaration of Competing Interest The author has no financial or other conflicts of interest to disclose., (Copyright © 2023 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.)

Mono-metal phosphorus trichalcogenides (MPX 3 ) have attracted intensive interest due to their intriguing magnetic properties and potential applications. Generally, single-layer two-dimensional (2D) MPX 3 are believed to be centrosymmetric. However, we discovered that unexpected spontaneous symmetry breaking may occur in some 2D MPX 3 , i.e. , vertical P-P dimers move out of the plane and become tilted, leading to the structural stability being enhanced, the inversion symmetry being simultaneously broken, and ferroelectricity or ferroelasticity emerging. By systematically investigating the family (176) of 2D MPX 3 , we found that 34 members undergo such symmetry breaking during geometric optimization, in which ten are identified to be dynamically stable. We show that the mismatch between the triangular sublattice of P-P dimers and the hexagonal sublattice of M atoms and the variable accommodation of P lone-pair electrons in different valence states of M atoms play dominant roles in the inversion symmetry breaking and the emergence of ferroicity. We obtained a ferroic atlas of the whole 2D MPX 3 family, which also includes many stable antiferromagnetic and non-ferroic members that have never been reported. Our work not only presents ferroelectricity in the 2D MPX 3 family but also reveals how diverse ferroicity emerges with various spontaneous symmetry breakings, which will be helpful for further exploration of 2D ferroic materials.

Background: The medicinal properties of plants can be predicted by virtue of phylogenetic methods, which nevertheless have not been utilized to explore the regularity of skin-related bioactivities of ethnomedicinal plants. We aim to investigate the distribution of skin efficacy of Asteraceae and Ranunculales plants on the species-level Tree of Life., Methods: The clinical efficacy data of 551 ethnomedicinal species belonging to Ranunculales, as well as 579 ethnomedicinal species of Asteraceae, were systematically collected and collated; these therapeutic data fell into 15 categories, including skin disease/cosmeceutical. The large phylogenetic tree of all China angiosperm species was used to detect the phylogenetic signals of ethnomedicinal plants by calculating the D statistic, phylogenetic diversity (PD), net relatedness index (NRI), and nearest taxon index (NTI). Of all Chinese ethnomedicinal plants of Ranunculales and Asteraceae, 339 (61.5% of all ethnomedicinal species) and 382 (66.0% of all) are used for skin problems. In Ranunculales, a clustered structure was suggested by the NRI value for skin uses. In Asteraceae, the skin utility was not clustered; Artemisia, Aster, Cremanthodium, Ligularia, and Saussurea are the most used Asteraceae genera for skin issues., Results: The clustering structure was identified in Artemisia, and the skin efficacy in other genera was of overdispersion (NRI < 0). NTI values and D statistics largely agree with NRI. When compared with PD values of different therapeutic categories, the PD value of the skin category was relatively high in Cremanthodium, Ranunculales, Asteraceae, and Artemisia, suggesting the enormous efficacy space in the new taxa of these taxonomic groups., Conclusion: By resolving the distribution of therapeutic effects of Ranunculales/Asteraceae taxa, the importance of phylogenetic methods in mining botanical resources with skin utilities is validated., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Intrinsic two-dimensional (2D) multiferroics that couple ferromagnetism and ferroelectricity are rare. Here, we present an approach to achieve 2D multiferroics using powerful intercalation technology. In this approach, metal atoms such as Cu or Ag atoms are intercalated in bilayer CrI 3 to form Cu(CrI 3 ) 4 or Ag(CrI 3 ) 4 . The intercalant leads to the inversion symmetry breaking and produces a large out-of-plane electric polarization with a low transition barrier and a small reversal electric field, exhibiting excellent 2D ferroelectric properties. In addition, due to charge transfer between the intercalated atoms and bilayer CrI 3 , the interlayer coupling transits from antiferromagnetic to ferromagnetic, and the intralayer ferromagnetic coupling is also enhanced. Furthermore, the built-in electric polarization causes a distinct surface magnetization difference, generating a strong magnetoelectric coupling with a coefficient larger than that of Fe, Co, and Ni thin films. Our work paves a practical path for 2D multiferroics, which may have crucial applications in spintronics.

Ranunculales, comprising of 7 families that are rich in medicinal species frequently utilized by traditional medicine and ethnomedicine, represents a treasure chest of biodiversity and chemodiversity. The phylogenetically related species often have similar chemical profile, which makes them often possess similar therapeutic spectrum. This has been validated by both ethnomedicinal experiences and pharmacological investigations. This paper summarizes molecular phylogeny, chemical constituents, and therapeutic applications of Ranunculales, i.e., a pharmacophylogeny study of this representative medicinal order. The phytochemistry/metabolome, ethnomedicine and bioactivity/pharmacology data are incorporated within the phylogenetic framework of Ranunculales. The most studied compounds of this order include benzylisoquinoline alkaloid, flavonoid, terpenoid, saponin and lignan, etc. Bisbenzylisoquinoline alkaloids are especially abundant in Berberidaceae and Menispermaceae. The most frequent ethnomedicinal uses are arthritis, heat-clearing and detoxification, carbuncle-abscess and sore-toxin. The most studied bioactivities are anticancer/cytotoxic, antimicrobial, and anti-inflammatory activities, etc. The pharmacophylogeny analysis, integrated with both traditional and modern medicinal uses, agrees with the molecular phylogeny based on chloroplast and nuclear DNA sequences, in which Ranunculales is divided into Ranunculaceae, Berberidaceae, Menispermaceae, Lardizabalaceae, Circaeasteraceae, Papaveraceae, and Eupteleaceae families. Chemical constituents and therapeutic efficacy of each taxonomic group are reviewed and the underlying connection between phylogeny, chemodiversity and clinical uses is revealed, which facilitate the conservation and sustainable utilization of Ranunculales pharmaceutical resources, as well as developing novel plant-based pharmacotherapy., (© 2022. The Chinese Journal of Integrated Traditional and Western Medicine Press and Springer-Verlag GmbH Germany, part of Springer Nature.)

Bipolar disorder (BD) is a complex psychiatric disorder with strong heritability. Identification of new BD risk genes will help determine the mechanism underlying disease pathogenesis. In the present study, we carried out whole genome sequencing for a Chinese BD family with three affected members and three unaffected members, and identified multiple candidate causal variations, including a frameshift mutation in the GOLGB1 gene. Since a GOLGB1 missense mutation was also found in another BD pedigree, we carried out functional studies by downregulating Golgb1 expression in the brain of neonatal mice. Golgb1 deficiency had no effect on anxiety, memory, and social behaviors in young adult mice. However, we found that young adult mice with Golgb1 deficiency exhibited elevated locomotor activity and decreased depressive behaviors in the tail suspension test and the sucrose preference test, but increased depressive behaviors in the forced swim test, resembling the dual character of BD patients with both mania and depression. Moreover, Golgb1 downregulation reduced PSD93 levels and Akt phosphorylation in the brain. Together, our results indicate that GOLGB1 is a strong BD risk gene candidate whose deficiency may result in BD phenotypes possibly through affecting PSD93 and PI3K/Akt signaling., (© 2022. The Author(s).)

Objective: Through aerobic exercise and diet intervention on obese mice, the effects of exercise and diet intervention on testicular oxidative stress and p38MAPK-NF-κB pathway were investigated in obese mice., Methods: Seventeen C57BL/6J mice were randomly divided into a normal diet group (ND), and 37 mice were divided into a high-fat diet group (HFD), the high-fat diet accounted for 40% of fat. After 12 weeks of feeding, 3 obesity-resistant mice were excluded from the HFD group, and the remaining 34 were successfully modeled. The mice in ND group were then divided into normal diet control group (NC, n =8) and normal diet and exercise group (NE, n =9). The mice in HFD group were divided into obese high-fat diet control group (OC, n =8), obese high-fat diet and exercise group (OE, n =9), obese normal diet group (ONC, n =8), and obese normal diet and exercise group (ONE, n =9). Each group continued to feed for 8 weeks, and the NE, OE and ONE groups performed treadmill exercise for 8 weeks at a speed of 20 m/min, 60 min/d, 6 d/week. Blood and testicular tissue samples were collected 36～40 h after the last exercise. Serum testosterone and testicular oxidative stress (MDA, T-SOD, T-AOC) levels were detected by ELISA, and testicular p38MAPK-NF-κB levels were detected by RT-PCR and Western blot., Results: Compared with the NC group, the body fat parameters, testicular MDA and testicular p38MAPK-NF-κB mRNA and protein levels in the OC group were increased significantly ( P ＜0.01), while the levels of testicular SOD, testis coefficient and blood testosterone were decreased significantly ( P ＜0.01); the body fat parameters of the mice in the NE group were decreased significantly ( P ＜0.05), and the serum level of testosterone was increased significantly ( P ＜0.01). Compared with the OC group, the body fat parameters, testicular MDA and testicular p38MAPK-NF-κB mRNA and protein levels were decreased significantly in the OE group ( P ＜0.05 or 0.01), and the testicular SOD and blood testosterone levels were increased significantly ( P ＜0.01); Body fat parameters, testicular MDA and testicular p38MAPK-NF-κB mRNA and protein levels were decreased significantly in ONC group ( P ＜0.01), while testicular SOD level and testis coefficient were increased significantly ( P ＜0.05); Body fat parameters, testicular MDA and testicular p38MAPK-NF-κB mRNA and protein levels of mice in ONE group were decreased significantly ( P ＜0.01), while testicular SOD, testis coefficient and blood testosterone levels were increased significantly ( P ＜0.01)., Conclusion: Obesity induces oxidative stress in the testis of mice, up-regulates the level of p38MAPK-NF-κB, and reduces the level of blood testosterone; exercise, diet and exercise*diet interventions can reduce testicular oxidative stress and down-regulate testicular p38MAPK-NF-κB levels by reducing body fat.

Podoplanin (PDPN) promotes platelet aggregation and activation by interacting with C-type lectin-like receptor 2(CLEC-2) on platelets. The interaction between the upregulated PDPN and platelet CLEC-2 stimulates venous thrombosis. PDPN was identified as a risk factor for coagulation and thrombosis in inflammatory processes. Hypercoagulability is defined as the tendency to develop thrombosis according to fibrinogen and/or D dimer levels. Nephrotic syndrome is also considered to be a hypercoagulable state. The aim of this study is to investigate the association of soluble PDPN/CLEC-2 with hypercoagulability in nephrotic syndrome. Thirty-five patients with nephrotic syndrome and twenty-seven healthy volunteers were enrolled. PDPN, CLEC-2 and GPVI concentrations were tested by enzyme-linked immunosorbent assay (ELISA). Patients with nephrotic syndrome showed higher serum levels of PDPN and GPVI in comparison to healthy controls ( P  < .001, P  = .001). PDPN levels in patients with nephrotic syndrome were significantly correlated with GPVI (r = 0.311; P  = .025), hypoalbuminemia (r = -0.735; P  < .001), hypercholesterolemia (r = 0.665; P  < .001), hypertriglyceridemia (r = 0.618; P  < .001), fibrinogen (r = 0.606; P  < .001) and D-dimer (r = 0.524; P  < .001). Area under the curve (AUC) for the prediction of hypercoagulability in nephrotic syndrome using PDPN was 0.886 (95% CI 0.804-0.967, P  < .001). Cut-off value for the risk probability was 5.88 ng/ml. The sensitivity of PDPN in predicting hypercoagulability was 0.806, and the specificity was 0.846. When serum PDPN was >5.88 ng/ml, the risk of hypercoagulability was significantly increased in nephrotic syndrome (OR = 22.79, 95% CI 5.92-87.69, P  < .001). In conclusion, soluble PDPN levels were correlated with hypercoagulability in nephrotic syndrome. PDPN has the better predictive value of hypercoagulability in nephrotic syndrome as well as was a reliable indicator of hypercoagulable state.

Objective: To establish a prediction model of renal calculus for university teachers to help them prevent renal calculus scientifically. This study involves a specific group of university teachers. We collected the physical examination index of 1043 university teachers in the Hubei University of Chinese Medicine in 2018 to build the model. We also used the physical examination data of 968 teachers in 2019 to verify the model., Materials and Methods: We used Lasso regression to screen the factors and logistic regression analysis to establish the model., Results: The models of this study included sex, age, DBP, TC, HDL. C, CEA, UA, ALT, GGT, HB, pH, RBC, RDW, and CLYMPH. Among these, sex, TC, ALT, HB, and LYMPH present high risks in the model. The result is of great significance related to the research of university teachers suffering from renal calculus. The C-index is 0.715, and the AUC is 0.7064., Conclusions: Based on the results of this study, we suggest that physical examination indicators can predict the risk of renal calculus and the individual probability of prevalence in specific groups. According to the risk of each physical examination index, it is possible to effectively prevent the occurrence of renal calculus in certain high-risk groups through lifestyle changes.

Inspired by experimentally discovering ferromagnetism and ferroelectricity in two-dimensional (2D) CrGeTe 3 and CuInP 2 S 6 with similar geometric structures, respectively, we systematically investigated ferroic properties in a large family of 2D M I M II Ge 2 X 6 (M I and M II = metal elements, X = S/Se/Te) by combining high-throughput first-principles calculations and the machine learning method. We identified 12 stable 2D multiferroics containing simultaneously ferromagnetic (FM) and ferroelectric (FE) properties and 35 2D ferromagnets without FE polarization. Particularly, the predicted FM Curie temperatures ( T C ) of eight 2D FM+FE semiconductors are close to or above room temperature. The ferroelectricity originates from the spontaneous geometric symmetry breaking induced by the unexpected shift of Ge-Ge atomic pairs and the emergence of Ge lone pair electrons, which also strengthens the p - d orbital hybridization between X atoms and metal atoms, leading to enhanced super-super-exchange interactions and raising the FM T C . Our findings not only enrich the family of 2D ferroic materials and present room-temperature FM semiconductors but also disclose the mechanism of the emerging ferroelectricity and enhanced ferromagnetism, which sheds light on the realization of high temperature multiferroics as well as FM semiconductors.

Beyond the conventional trial-and-error method, machine learning offers a great opportunity to accelerate the discovery of functional materials, but still often suffers from difficulties such as limited materials data and the unbalanced distribution of target properties. Here, we propose the ab initio Bayesian active learning method that combines active learning and high-throughput ab initio calculations to accelerate the prediction of desired functional materials with ultrahigh efficiency and accuracy. We apply it as an instance to a large family (3119) of two-dimensional hexagonal binary compounds with unbalanced materials properties, and accurately screen out the materials with maximal electric polarization and proper photovoltaic band gaps, respectively, whereas the computational costs are significantly reduced by only calculating a few tenths of the possible candidates in comparison with a random search. This approach shows the enormous advantages for the cases with unbalanced distribution of target properties. It can be readily applied to seek a broad range of advanced materials.

Ten new Daphniphyllum alkaloids, calycindaphines A-J (1-10), together with seventeen known alkaloids were isolated from the roots of Daphniphyllum calycinum . Their structures were established by extensive spectroscopic methods and compared with data from literature. Compound 1 is a novel alkaloid with a new rearrangement C 22 skeleton with the 5/8/7/5/5 ring system. Compound 2 represents the second example of calyciphylline G-type alkaloids. Compound 10 is the first example of secodaphniphylline-type alkaloid absent of the oxygen-bridge between C-25/C-29. The possible biogenetic pathways of 1 and 2 were also proposed. All the isolated compounds were evaluated for their bioactivities in three cell models. Compounds 22, 23, and 26 showed significant NF-κB transcriptional inhibitory activity at a concentration of 50 μM. Compounds 16 and 18 exhibited significant TGF-β inhibitory activity in HepG2 cells. Compounds 24 and 26 induced autophagic puncta and mediated the autophagic marker LC3-II conversion in HEK293 cells., Competing Interests: There are no conflicts to declare., (This journal is © The Royal Society of Chemistry.)

Ferroelectricity and metallicity are usually believed not to coexist because conducting electrons would screen out static internal electric fields. In 1965, Anderson and Blount proposed the concept of "ferroelectric metal", however, it is only until recently that very rare ferroelectric metals were reported. Here, by combining high-throughput ab initio calculations and data-driven machine learning method with new electronic orbital based descriptors, we systematically investigated a large family (2964) of two-dimensional (2D) bimetal phosphates, and discovered 60 stable ferroelectrics with out-of-plane polarization, including 16 ferroelectric metals and 44 ferroelectric semiconductors that contain seven multiferroics. The ferroelectricity origins from spontaneous symmetry breaking induced by the opposite displacements of bimetal atoms, and the full-d-orbital coinage metal elements cause larger displacements and polarization than other elements. For 2D ferroelectric metals, the odd electrons per unit cell without spin polarization may lead to a half-filled energy band around Fermi level and is responsible for the metallicity. It is revealed that the conducting electrons mainly move on a single-side surface of the 2D layer, while both the ionic and electric contributions to polarization come from the other side and are vertical to the above layer, thereby causing the coexistence of metallicity and ferroelectricity. Van der Waals heterostructures based on ferroelectric metals may enable the change of Schottky barrier height or the Schottky-Ohmic contact type and induce a dramatic change of their vertical transport properties. Our work greatly expands the family of 2D ferroelectric metals and will spur further exploration of 2D ferroelectric metals., Competing Interests: Conflict of interest The authors declare that they have no conflict of interest., (Copyright © 2020 Science China Press. Published by Elsevier B.V. All rights reserved.)

Regression machine learning is widely applied to predict various materials. However, insufficient materials data usually leads to poor performance. Here, we develop a new voting data-driven method that could generally improve the performance of the regression learning model for accurately predicting properties of materials. We apply it to investigate a large family (2135) of two-dimensional hexagonal binary compounds focusing on ferroelectric properties and find that the performance of the model for electric polarization is indeed greatly improved, where 38 stable ferroelectrics with out-of-plane polarization including 31 metals and 7 semiconductors are screened out. By unsupervised learning, actionable information such as how the number and orbital radius of valence electrons, ionic polarizability, and electronegativity of constituent atoms affect polarization was extracted. Our voting data-driven method not only reduces the size of materials data for constructing a reliable learning model but also enables one to make precise predictions for targeted functional materials.

Objective: To analyze the pathogens of lower respiratory tract infection(LRTI) including bacterial, viral and mixed infection, and to establish a discriminant model based on clinical features in order to predict the pathogens. Methods: A total of 243 hospitalized patients with lower respiratory tract infections were enrolled in Fujian Provincial Hospital from April 2012 to September 2015. The clinical data and airway (sputum and/or bronchoalveolar lavage) samples were collected. Microbes were identified by traditional culture (for bacteria), loop-mediated isothermal amplification(LAMP) and gene sequencing (for bacteria and atypical pathogen), or Real-time quantitative polymerase chain reaction (Real-time PCR)for viruses. Finally, a discriminant model was established by using the discriminant analysis methods to help to predict bacterial, viral and mixed infections. Results: Pathogens were detected in 53.9% (131/243) of the 243 cases.Bacteria accounted for 23.5%(57/243, of which 17 cases with the virus, 1 case with Mycoplasma pneumoniae and virus), mainly Pseudomonas Aeruginosa and Klebsiella Pneumonia. Atypical pathogens for 4.9% (12/243, of which 3 cases with the virus, 1 case of bacteria and viruses), all were mycoplasma pneumonia. Viruses for 34.6% (84/243, of which 17 cases of bacteria, 3 cases with Mycoplasma pneumoniae, 1 case with Mycoplasma pneumoniae and bacteria) of the cases, mainly Influenza A virus and Human Cytomegalovirus, and other virus like adenovirus, human parainfluenza virus, respiratory syncytial virus, human metapneumovirus, human boca virus were also detected fewly. Seven parameters including mental status, using antibiotics prior to admission, complications, abnormal breath sounds, neutrophil alkaline phosphatase (NAP) score, pneumonia severity index (PSI) score and CRUB-65 score were enrolled after univariate analysis, and discriminant analysis was used to establish the discriminant model by applying the identified pathogens as the dependent variable. The total positive predictive value was 64.7%(77/119), with 66.7% for bacterial infection, 78.0% for viral infection and 33.3% for the mixed infection. Conclusions: The mostly detected pathogens were Pseudomonas aeruginosa, atypitcal pathogens, Klebsiella pneumoniae, influenza A virus and human cytomegalovirus in hospitalized patients with LRTI in this hospital. The discriminant diagnostic model established by clinical features may contribute to predict the pathogens of LRTI.

Objectives: Some changes are found in the labyrinth anatomy during postnatal development. Although the spatial orientation of semicircular canals was thought to be stable after birth, we investigated the age-related orientational changes of human semicircular canals during development., Methods: We retrospectively studied the computed tomography (CT) images of both ears of 76 subjects ranged from 1 to 70 years old. They were divided into 4 groups: group A (1-6 years), group B (7-12 years), group C (13-18 years), and group D (>18 years). The anatomical landmarks of the inner ear structures were determined from CT images. Their coordinates were imported into MATLAB software for calculating the semicircular canals orientation, angles between semicircular canal planes and the jugular bulb (JB) position. Differences between age groups were analyzed using multivariate statistics. Relationships between variables were analyzed using Pearson analysis., Results: The angle between the anterior semicircular canal plane and the coronal plane, and the angle between the horizontal semicircular canal plane and the coronal plane were smaller in group D than those in group A (P<0.05). The JB position, especially the anteroposterior position of right JB, correlated to the semicircular canals orientation (P<0.05). However, no statistically significant differences in the angles between ipsilateral canal planes among different age groups were found., Conclusion: The semicircular canals had tendencies to tilt anteriorly simultaneously as a whole with age. The JB position correlated to the spatial arrangement of semicircular canals, especially the right JB. Our calculation method helps detect developmental and pathological changes in vestibular anatomy.

Conclusion: The cochleae of children over 6 years old and adults displaced more outward, backward, and downward in comparison with those of children under 6 years. However, the cochlear orientation does not significantly change during postnatal development. Adjacent structures correlated with the cochlear position., Objective: To test whether the cochlear position and orientation, which are important in cochlea implant surgery, change during postnatal development., Methods: CT images of both ears of 76 human subjects were studied. They were divided into three groups: group A (1-6 years old), group B (7-18 years old), and group C (>18 years old)., Results: The distances from the cochlea to the median sagittal and coronal planes in group A were smaller than those in group B and group C (p < 0.05), but the distance from it to the Frankfurt plane in group A was larger than that in group C (p < 0.05). The volume of the temporal bone pneumatization and the positions of the jugular bulb and the intrapetrous internal carotid artery positively correlated with the cochlear position (p < 0.05). There were no statistically significant differences in the angles between the central axis of the cochlea and these coordinate planes among age groups.