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Bioimpedance analysis (BIA)–body composition monitoring (BCM) has been used to evaluate the hydration and nutritional status of adults and children on dialysis. However, its clinical application still has challenges, so further exploration is valuable. We used BIA-BCM to evaluate the hydration and nutritional status of children undergoing chronic peritoneal dialysis from 1 July 2021 to 31 December 2022 in the Children’s Hospital of Fudan University to explore the clinical value of this method. A total of 84 children on chronic peritoneal dialysis (PD) were included. In the PD group, 16 (19.05%) and 31 (36.90%) had mild and severe overhydration (OH), respectively; 41.27% (26/63) had a low lean tissue index (LTI). In the PD group, patients with relative OH (Re-OH) > 5.6% had significantly higher systolic blood pressure (SBP) and SBP z score (SBPz). Patients with LTI > 12% had significantly higher body mass index (BMI) and BMI z score (BMIz). Canonical correlation analysis indicated a linear relationship (ρ = 0.708) between BIA-BCM hydration and the clinical hydration indicator and a linear relationship (ρ = 0.995) between the BIA-BCM nutritional indicator and the clinical nutritional indicator. A total of 56% of children on chronic peritoneal dialysis had OH, and 41% had a low LTI. In PD patients, SBP and SBPz were correlated with BIA-BCM Re-OH, and BMI and BMIz were correlated with BIA-BCM LTI. BIA-BCM indicators have good clinical value in evaluating hydration and nutrition.

Thermoacoustic oscillation is a significant challenge in the development of advanced thermal power and propulsion systems. The present work focuses on the whistling phenomenon in the practical burners of a developing high-efficiency domestic gas stove. The acoustic analysis is conducted by a Helmholtz acoustic solver, identifying the 1/2 wave longitudinal mode in the outer ring or center nozzle and its upstream pipe and estimating the modal eigenfrequencies fa=599Hz and fb=647Hz which are close to the main frequency of the whistling measured in experiments. The sequential flame images captured by a high-speed camera are processed by a dynamic mode decomposition method to illustrate flame structure oscillations at the peak frequency mode. The results verify that thermoacoustic oscillations are the generation mechanism of the whistling and display the periodic fluctuation characteristics of the flame and the spatial distribution of heat release. Moreover, both structural fine-tuning designs help to achieve better suppression for thermoacoustic oscillations and avoid the whistling phenomenon. These structural fine-tuning strategies have been researched for several decades but rarely reported to be applied to industrial burners in previous work. Motivated by this, it will provide a new insight into the investigation of burner structures on thermoacoustic behaviors and the application of these passive control strategies.

Abstract Purpose Obstructive sleep apnea (OSA) is a common sleep-breathing disorder. Numerous investigations have found a strong inherent relationship between OSA and hypothyroidism. Studies suggest that lymphocytes may be involved in the development of hypothyroidism in patients with OSA. This study aimed to assess the association between lymphocytes and hypothyroidism in OSA patients. Patients and methods This study involved 920 patients with OSA who underwent nocturnal sleep monitoring, thyroid function testing, and routine blood tests. In patients with OSA, logistic regression analysis indicated independent predictors of hypothyroidism. The cutoff level of lymphocyte count was determined using a receiver operating characteristic (ROC) analysis to predict the occurrence of hypothyroidism in individuals with OSA. Results This study comprised 920 OSA patients (617 males and 303 women), 879 with normal thyroid function, and 41 with hypothyroidism, with a hypothyroidism incidence of 4.46%. In the entire OSA population and male OSA patients, the number of lymphocytes was significantly higher in the hypothyroid group than in the control group (p = 0.002 and 0.020, respectively). In addition, among the OSA population younger than 60 years old and patients with mild to moderate OSA, lymphocytes were found to be considerably more in the hypothyroid group than in the euthyroid group. Lymphocyte count, ESS, and sex were all independent predictors of hypothyroidism development in OSA patients. According to ROC curve analysis, the risk of hypothyroidism increases with increasing lymphocyte count in the total patient population, with an optimal diagnostic cutoff point of 2.5 (× 10*9/L). Conclusions The prevalence of hypothyroidism in patients with OSA increases as the number of lymphocytes increases. Lymphocyte count can be used as an independent predictor of the occurrence of hypothyroidism, and it has a diagnostic value for OSA combined with hypothyroidism.

Abstract Persistence of CAR-T cell function is associated with relapse rate after CAR-T therapy, while co-stimulatory agents are highly concerned with the persistence of CAR-T cells. In this study, we designed and constructed a series of BCMA-targeting second-generation CAR constructs containing CD28, 41BB, and OX40 molecules, respectively, to identify the costimulatory domains most favorable for persistence. The results of routine in vitro studies showed that OX40-CAR-T and 41BB-CAR-T had similar antitumor effects and were superior to CD28-CAR-T in terms of proliferation and cytotoxicity. Although difficult to distinguish by conventional functional assays, OX40-CAR-T cells exhibited greater proliferation and enhanced immune memory than 41BB-CAR-T cells with the repeated stimulation assay by BCMA-expressing target cells. In vivo studies further demonstrated that OX40-CAR-T cells had stronger proliferative activity than 41BB-CAR-T cells, which was highly consistent with the in vitro antitumor activity and proliferation results. Our study provides for the first time a scientific basis for designing OX40-CAR-T cell therapy to improve relapse in patients with MM after CAR-T treatment.

Although chimeric antigen receptor (CAR) T cell immunotherapy has shown promising significance in B cell malignancies, success against T cell malignancies remains unsatisfactory because of shared antigenicity between normal and malignant T cells, resulting in fratricide and hindering CAR production for clinical treatment. Here, we report a new strategy of blocking the CD7 antigen on the T cell surface with a recombinant anti-CD7 antibody to obtain a sufficient amount of CD7-targeting CAR-T cells for T cell acute lymphoblastic leukemia (T-ALL) treatment. Feasibility was evaluated systematically, revealing that blocking the CD7 antigen with an antibody effectively blocked CD7-derived fratricide, increased the expansion rate, reduced the proportion of regulatory T (Treg) cells, maintained the stem cell-like characteristics of T cells, and restored the proportion of the CD8+ T cell population. Ultimately, we obtained anti-CD7 CAR-T cells that were specifically and effectively able to kill CD7 antigen-positive target cells, obviating the need for complex T cell modifications. This approach is safer than previous methods and provides a new, simple, and feasible strategy for clinical immunotherapies targeting CD7-positive malignant tumors.

Abstract Research on mobile robots began in the late 1960s. Mobile robots are a typical autonomous intelligent system and a hot spot in the high-tech field. They are the intersection of multiple technical disciplines such as computer artificial intelligence, robotics, control theory and electronic technology. The product not only has potentially very attractive application value and commercial value, but the research on it is also a challenge to intelligent technology. The development of mobile robots provides excellent research for various intelligent technologies and solutions. This dissertation aims to study the research of multi-sensor information fusion and intelligent optimization methods and the methods of applying them to mobile robot related technologies, and in-depth study of the construction of mobile robot maps from the perspective of multi-sensor information fusion. And, in order to achieve this function, combined with autonomous exploration and other related theories and algorithms, combined with the Robot Operating System (ROS). This paper proposes the area equalization method, equalization method, fuzzy neural network and other methods to promote the realization of related technologies. At the same time, this paper conducts simulation research based on the SLAM comprehensive experiment of the JNPF-4WD square mobile robot. On this basis, the high precision and high reliability of robot positioning are further realized. The experimental results in this paper show that the maximum error of the X-axis and Y-axis, FastSLAM algorithm is smaller than EKF algorithm, and the improved FASTSALM algorithm error is further reduced compared with the original FastSLAM algorithm, the value is less than 0.1.

Abstract Background Pathogenic variants of PAX2 cause autosomal-dominant PAX2-related disorder, which includes variable phenotypes ranging from renal coloboma syndrome (RCS), congenital anomalies of the kidney and urinary tract (CAKUT) to nephrosis. Phenotypic variability makes it difficult to define the phenotypic spectrum associated with genotype. Methods We collected the phenotypes in patients enrolled in the China national multicenter registry who were diagnosed with pathogenic variant in PAX2 and reviewed all published cases with PAX2-related disorders. We conducted a phenotype-based cluster analysis by variant types and molecular modeling of the structural impact of missense variants. Results Twenty different PAX2 pathogenic variants were identified in 32 individuals (27 families) with a diagnosis of RCS (9), CAKUT (11) and nephrosis (12) from the Chinese cohort. Individuals with abnormal kidney structure (RCS or CAKUT group) tended to have likely/presumed gene disruptive (LGD) variants (Fisher test, p

BackgroundThe duration of initial corticosteroid therapy in newly diagnosed Idiopathic nephrotic syndrome (INS) is about 3 months. Our study was designed to test the feasibility of a shorter duration of corticosteroid therapy in newly diagnosed INS who show a quicker response.MethodsPatients who responded within 10 days (Group A) received 8 weeks of corticosteroid therapy as compared to 12–14 weeks of standard therapy in those who responded between >10 days to 28 days (Group B), and follow up for 52 weeks. The primary endpoint is time to first relapse after treatment completion. (NCT03878914, March 18, 2019)ResultsA total of 33 children with INS were enrolled and the follow-up data were analyzed. The clinical and laboratory characteristics of patients in both groups were similar. No significant difference was found in time to first relapse [65(14.5, 159) days for Group A vs. 28(17, 61.5) days for Group B, P = 0.371], the incidence of frequently relapsing nephrotic syndrome [6/18 (33.3%) vs. 5/10(50%), P = 0.644] or requirement for alternative immunosuppressant [4/18 (22.2%) vs. 1/10 (10%), P = 0.769]. Group A received similar corticosteroid dose compare with Group B (3511 ± 2421 mg/m2 vs. 4117 ± 2556 mg/m2, P = 0.524). Frequency and severity of corticosteroid-related complications was similar in both groups.ConclusionsThe time to first relapse and the number of relapses per patient were comparable between the two groups. However, more patients in Group A relapsed and the mean total dose of prednisolone for the study period was very similar between the two groups.

BackgroundHypothyroidism could cause obstructive sleep apnea (OSA), however, the specific association of them remained unclear. This cross-sectional study aimed to determine the prevalence of hypothyroidism among patients with OSA, and the characteristics and predictors of hypothyroidism associated with OSA.MethodsA total of 573 patients with OSA were included in the study. Serum levels of thyroid stimulating hormone (TSH), free triiodothyronine (FT3) and free thyroxine (FT4) were measured in all participants. Univariate and binary logistic regression analysis were performed to assess the association of OSA with hypothyroidism while controlling for potential confounders. Receiver operating characteristic (ROC) curve analysis was performed to evaluate the OSA effect in the distinction between euthyroid and hypothyroidism.ResultsThe prevalence of hypothyroidism was 6.75%、5.12%、10.38% in the total, men, and women cohort, respectively, and the prevalence rate in women OSA patients was significantly higher than that in men OSA patients (P=0.018). The men OSA patients with hypothyroidism had a higher Epworth sleepiness scale (ESS) than women OSA patients with hypothyroidism (P=0.022). Additionally, the ESS was significantly higher in men OSA patients with hypothyroidism than those with euthyroid (P=0.042), while women OSA patients had no such difference (P=0.822). In men patients with OSA, ROC curve analyses revealed that the risk of hypothyroidism increased in accordance with increasing ESS after adjustment for potential confounders, and the optimal cutoff value was 10 score. Higher ESS category was significantly associated with a higher risk of prevalent hypothyroidism in men patients with OSA [odds ratio (OR) = 4.898 for ESS≥10 relative to ESS

Introduction Rituximab (RTX) effectively prevents relapses in patients with complicated steroid-sensitive nephrotic syndrome (SSNS). The 1-year relapse-free survival rate is approximately 30% in children after the first episode of SSNS treated with standardised corticosteroids. Whether the benefits of RTX extend to the first relapse are unknown. The efficacy and safety of RTX in the first episode of paediatric idiopathic nephrotic syndrome (RTXFIRPedINS) trial (NCT04783675) will assess its effect on the risk of subsequent relapse.Methods and analysis RTXFIRPedINS is an open-label, single-arm, multicentre trial targeting patients aged 1–18 years with a first episode of SSNS. All patients will receive standardised corticosteroid treatment for 12 weeks. A sample size of 44 patients provides 80% power to detect a 20% increase in the 1-year relapse-free rate, assuming a dropout rate of 10%. After obtaining informed consent and screening, eligible patients will be treated with a single intravenous infusion of 375 mg/m2 RTX within 1 week after achieving remission. Trimethoprim-sulfamethoxazole will be administered for 3 months after RTX administration to prevent Pneumocystis carinii infection. The follow-up period will be 1 year. The primary outcome is the 1-year relapse-free survival rate after RTX infusion. The secondary study outcomes are the number of days from the infusion of RTX to the occurrence of the first relapse, 6-month relapse-free survival rate, the B cell recovery time and treatment-related adverse events. Immunological factors will be studied as predictors of response.Ethics and dissemination This trial was approved by the Ethics Committee of the Children’s Hospital of Fudan University and seven local ethics committees. We will publish our study results in peer-reviewed journals and present them at international scientific meetings.Trial registration number NCT04783675

Background: Gen1 mutation can cause various phenotypes of congenital anomaly of the kidney and urinary tract (CAKUT). An intrauterine low-protein isocaloric diet can also cause CAKUT phenotypes in offspring. However, single factors such as gene mutation or abnormal environmental factor during pregnancy can only explain part of the pathogenesis of CAKUT. Objectives: A low-protein isocaloric diet was fed to Gen1-mutant mice throughout pregnancy to establish a Gen1-mutant mouse model exposed to a low-protein isocaloric intrauterine environment. The mice were divided into 4 groups: normal (22%) protein diet (ND) + wild-type mice (CON group), ND + Gen1PB/+ mice (Gen1PB/+ group), low (6%)-protein isocaloric diet (LD) + wild-type mice (LD group), and the LD + Gen1PB/+ groups. Methods: The experimental design included observing proportion and distribution of CAKUT phenotypes of neonatal mice; evaluating the number of ureteric buds (UBs) on embryonic day (E) 11.5, the location of UBs on E11.5, and length of the common nephric duct (CND); isolating embryonic kidneys on E11.5 from the Gen1PB/+ group and culturing embryonic kidneys in medium containing 10% serum or serum-free medium to observe the branching of UBs; and detecting the p-PLCγ, p-Akt, and p-ERK1/2 in UBs and CND on E11.5, as well as the apoptosis and proliferation of tissues by immunofluorescence staining. Results: We found that the incidence of CAKUT in offspring of Gen1PB/+ mice under an intrauterine low-protein isocaloric diet environment was significantly increased, and a duplicated collecting system was the dominant phenotype of CAKUT. During the early stage of metanephric development, ectopic protrusion of UBs may appear and lower locations of UBs in Gen1PB/+ mice under an intrauterine low-protein isocaloric diet environment and the number of UB branches in the serum-free culture condition significantly decreased. Further examination revealed that p-PLCγ signaling and tissue apoptosis were abnormal in UBs and the CND at the early stage of kidney development. Conclusions: The aforementioned findings suggest that an intrauterine low-protein isocaloric diet can aggravate the occurrence of CAKUT in Gen1-mutant mice, which might affect key steps in the metanephric development, such as the protrusion of UBs, which might be related to mediate UBs and CND apoptosis through p-PLCγ signaling.

The signal transmission mechanism of the Resistor-Capacitor (RC) circuit is similar to the intracellular and extracellular signal propagating mechanism of the neuron. Thus, the RC circuit can be utilized as the circuit model of the neuron cell membrane. However, resistors are electronic components with the fixed-resistance and have no memory properties. A memristor is a promising neuro-morphological electronic device with nonvolatile, switching, and nonlinear characteristics. First of all, we consider replacing the resistor in the RC neuron circuit with a memristor, which is named the Memristor-Capacitor (MC) circuit, then the MC neuron model is constructed. We compare the charging and discharging processes between the RC and MC neuron circuits. Secondly, two models are compared under the different external stimuli. Finally, the synchronous and asynchronous activities of the RC and MC neuron circuits are performed. Extensive experimental results suggest that the charging and discharging speed of the MC neuron circuit is faster than that of the RC neuron circuit. Given sufficient time and proper external stimuli, the RC and MC neuron circuits can produce the action potentials. The synchronous and asynchronous phenomena in the two neuron circuits reproduce nonlinear dynamic behaviors of the biological neurons.

The Izhikevich (IZH) spiking neuron model can display spiking and bursting behaviors of neurons. Based on the switching property and bio-plausibility of the memristor, the memristive Izhikevich (MIZH) spiking neuron model is built. Firstly, the MIZH spiking model is introduced and used to generate 23 spiking patterns. We compare the 23 spiking patterns produced by the IZH and MIZH spiking models. Secondly, the MIZH spiking model actively reproduces various neuronal behaviors, including the excitatory cortical neurons, the inhibitory cortical neurons, and other cortical neurons. Finally, the collective dynamic activities of the MIZH neuronal network are performed, and the MIZH oscillatory network is constructed. Experimental results illustrate that the constructed MIZH spiking neuron model performs high firing frequency and good frequency adaptation. The model can easily simulate various spiking and bursting patterns of distinct neurons in the brain. The MIZH neuronal network realizes the synchronous and asynchronous collective behaviors. The MIZH oscillatory network can memorize and retrieve the information patterns correctly and efficiently with high retrieval accuracy.

The leaky integrate-and-fire (LIF) spiking model can successively mimic the firing patterns and information propagation of a biological neuron. It has been applied in neural networks, cognitive computing, and brain-inspired computing. Due to the resistance variability and the natural storage capacity of the memristor, the LIF spiking model with a memristor (MLIF) is presented in this article to simulate the function and working mode of neurons in biological systems. First, the comparison between the MLIF spiking model and the LIF spiking model is conducted. Second, it is experimentally shown that a single memristor could mimic the function of the integration and filtering of the dendrite and emulate the function of the integration and firing of the soma. Finally, the feasibility of the proposed MLIF spiking model is verified by the generation and recognition of Morse code. The experimental results indicate that the presented MLIF model efficiently performs good biological frequency adaptation, high firing frequency, and rich spiking patterns. A memristor can be used as the dendrite and the soma, and the MLIF spiking model can emulate the axon. The constructed single neuron can efficiently complete the generation and propagation of firing patterns.

Objective: To observe the effect of Wuweizi syrup on brain aging mice model induced by d-galactose in mice. Methods: 72 mice were randomly divided into blank group, model group, naokangling group and low, middle and high dose Wuweizi syrup group. After 3 days of adaptive feeding, except for the blank group, the rest mice were subcutaneously (sc) injected with d-galactose 1.25 g/kg at neck back to replicate the aging model. Sc injection was given for 40 consecutive days, and corresponding drugs were given by gavage on the 11th day of modeling. On the 39th day, the dark experiment was carried out to measure the learning ability of mice. After the last administration for 2 h, brain, liver, thymus and spleen were taken and weighed to calculate the organ index. Blood was taken and CAT, GSH and SOD levels in whole blood were determined. Some brain and liver tissues were taken to prepare homogenates, and MDA levels in tissue homogenates and plasma were measured. Brain, liver, thymus and spleen were stained with HE, and pathological sections were made for observation under light microscope. Results: Compared with the blank group, in the model group, the incubation period of mice was significantly reduced and the number of shuttle back and forth was significantly increased (P

Noise source identification is the first key step to reduce the noise pressure level of the carpet tufting machine. For identifying the main noise sources of the carpet tufting machine, the single channel blind source separation (SCBSS) method is proposed to separate the acquired single channel noise, and the time-frequency signal analysis is applied to identify separated noise components. The SCBSS includes ensemble empirical mode decomposition (EEMD), improved Akaike information criterion (AIC) source number estimation and fast independent component analysis (FastICA). The separation method based on EEMD-AIC-FastICA not only overcomes traditional blind source separation problems that require enough test channel numbers, but also solves the problem that the number of virtual multichannel signals is unknown. Four independent components (ICs) are obtained after using the SCBSS. Combining the time-frequency analysis of the four ICs and the acquired vibration signals of six main components, the specific four noise sources can be identified. The four ICs correspond to the noise of needles, noise of hooks, noise of hook driven shaft, and noise of motor spindle, respectively.

The deformation mechanism and texture evolution of AZ31 Mg alloy compressed in three different directions at room temperature were studied, and the relationship between the two was compared through experiments and viscoplastic self-consistent (VPSC) modeling. Setting up only one specific deformation mode was the predominant mechanism by changing the CRSS ratio for the different deformation modes. The following conclusions were drawn: (1) It was demonstrated that basal slip causes a slow and continuous deflection of the grain toward the transverse direction (TD). When the sample is compressed in the extruded direction (ED), prismatic slip leads to grains being deflected toward the ED in the initial stages of compression, and when the sample is compressed 45° to the extrusion direction (45ED) and perpendicular to the extrusion direction (PED), prismatic slip contributes little to the texture evolution. (2) When the sample is compressed along three different directions, pyramidal slip leads to the grain being deflected toward the normal direction (ND), and the {10-12} extension twin deflects the grain at a large angle. (3) When only the {10-11} compression twin is activated, the grain will be deflected in the ND while the sample is compressed along the ED and 45ED, but when the sample is compressed in the PED, the grains are concentrated from both sides of the ED to the center.

The Hodgkin-Huxley (HH) spiking neuron model reproduces the dynamic characteristics of the neuron by mimicking the action potential, ionic channels, and spiking behaviors. The memristor is a nonlinear device with variable resistance. In this paper, the memristor is introduced to the HH spiking model, and the memristive Hodgkin-Huxley spiking neuron model (MHH) is presented. We experimentally compare the HH spiking model and the MHH spiking model by applying different stimuli. First, the individual current pulse is injected into the HH and MHH spiking models. The comparison between action potentials, current densities, and conductances is carried out. Second, the reverse single pulse stimulus and a series of pulse stimuli are applied to the two models. The effects of current density and action time on the production of the action potential are analyzed. Finally, the sinusoidal current stimulus acts on the two models. The various spiking behaviors are realized by adjusting the frequency of the sinusoidal stimulus. We experimentally demonstrate that the MHH spiking model generates more action potential than the HH spiking model and takes a short time to change the memductance. The reverse stimulus cannot activate the action potential in both models. The MHH spiking model performs smoother waveforms and a faster speed to return to the resting potential. The larger the external stimulus, the faster action potential generated, and the more noticeable change in conductances. Meanwhile, the MHH spiking model shows the various spiking patterns of neurons.

Abstract Background The substantial increase in cardiovascular diseases (CVD) in China over the last three decades warrants comprehensive preventive primary and secondary strategies. Prolonged prehospital delay (PHD) has been identified as a substantial barrier to timely therapeutic interventions for acute myocardial infarction (AMI). Despite worldwide efforts to decrease the patient’s decision-making time, minimal change has been achieved so far. Here, we aim to describe the conceptual framework and methods and outline key data of the MEDEA FAR-EAST Study, which aimed to elucidate in-depth barriers contributing to delay in Chinese AMI-patients. Methods Data sources of this multicenter cross-sectional observational study are a standardized bedside interview, a self-administered tailored questionnaire tool and the patient chart. PHD was defined as the main outcome and triangulated at bedside. Standard operation procedures ensured uniform data collection by trained study personnel. The study was ethically approved by Tongji-Hospital and applied to all participating hospitals. Results Among 379 consecutively screened patients, 296 (78.1%) fulfilled eligibility criteria. A total of 241 (81.4%) AMI-patients were male and 55 (18.6%) female. Mean age was 62.9 years. Prehospital delay time was assessed for 294 (99.3%) patients. Overall median PHD was 151 min with no significant sex difference. Symptom mismatch was present in 200 (69.7%) patients and 106 (39.0%) patients did not attribute their symptoms to cardiac origin. A total of 33 (12.4%) patients suffered from depression, 31 (11.7%) from anxiety and 141 (53.2%) patients employed denial as their major coping style. Conclusion This is the first study on prehospital delay with emphasis on psychological variables in Chinese AMI-patients. A comprehensive assessment tool to measure clinical and psychological factors was successfully implemented. Socio-demographic key data proved a good fit into preexisting Chinese literature. Potential barriers including cardiac denial and symptom-mismatch were assessed for the first time in Chinese AMI-patients. The pretested selection of instruments allows future in depth investigations into barriers to delay of Chinese AMI-patients and enables inter-cultural comparisons.

Objective: To analyse the clinical manifestations, aetiology, prognosis, and risk factors of fungal peritonitis (FP) in children on peritoneal dialysis (PD).Methods: Among 322 children undergoing PD at Children's Hospital of Fudan University, between January 2001 and December 2019, FP cases were retrospectively analysed and compared with those of bacterial peritonitis (BP) to analyse the risk factors of FP.Results: A total of 124 cases of peritonitis were treated, including 11 FP cases in 11 children (0.0019 episodes/patient*month) and 113 BP cases in 64 children (0.02 episodes/patient*month). Among the 11 FP cases, 7 cases (63.64%) were caused by Candida and Candida parapsilosis (5/7) was the most common pathogen of Candida. All FP patients were converted to haemodialysis (HD) and did not resume PD during follow-up. Two patients (18.2%) died after 6 months of HD due to heart failure, 2 patients underwent kidney transplant after 2 years of infection, and the other 7 patients were still on HD. The univariate analysis showed the usage rate of antibiotics in the month before the onset of peritonitis was higher (45.45 vs. 15.93%) and the mean serum albumin was lower (31.4 vs. 34.4 g/L) in the FP group when compared with BP group (P < 0.05), while multivariate analysis showed that serum albumin ≤ 30 g/L was an independent risk factor for FP (odds ratio 4.896, 95% confidence interval 1.335–17.961).Conclusion: FP is a rare complication of PD in children, but it is associated with high technique failure. Attention should be paid to hypoproteinaemia and antibiotic use in children on PD.

Congenital nephrogenic diabetes insipidus (NDI) is a rare genetic disorder characterized by renal inability to concentrate urine. We utilized a multicenter strategy to investigate the genotype and phenotype in a cohort of Chinese children clinically diagnosed with NDI from 2014 to 2019. Ten boys from nine families were identified with mutations in AVPR2 or AQP2 along with dehydration, polyuria–polydipsia, and severe hypernatremia. Genetic screening confirmed the diagnosis of seven additional relatives with partial or subclinical NDI. Protein structural analysis revealed a notable clustering of diagnostic mutations in the transmembrane region of AVPR2 and an enrichment of diagnostic mutations in the C-terminal region of AQP2. The pathogenic variants are significantly more likely to be located inside the domain compared with population variants. Through the structural analysis and in silico prediction, the eight mutations identified in this study were presumed to be disease-causing. The most common treatments were thiazide diuretics and non-steroidal anti-inflammatory drugs (NSAIDs). Emergency treatment for hypernatremia dehydration in neonates should not use isotonic saline as a rehydration fluid. Genetic analysis presumably confirmed the diagnosis of NDI in each patient in our study. We outlined methods for the early identification of NDI through phenotype and genotype, and outlined optimized treatment strategies.

Congenital anomalies of the kidney and urinary tract (CAKUT) is a common birth defect and is the leading cause of end-stage renal disease in children. The etiology of CAKUT is complex and includes mainly genetic and environmental factors. However, these factors cannot fully explain the etiological mechanism of CAKUT. Recently, participation of long non-coding RNAs (lncRNAs) in the development of the circulatory and nervous systems was demonstrated; however, the role of lncRNAs in the development of the kidney and urinary tract system is unclear. In this study, we used the piggyBac (PB) transposon-based mutagenesis to construct a mouse with lncRNA 4933425B07Rik (Rik) PB insertion (RikPB/PB) and detected overexpression of Rik and a variety of developmental abnormalities in the urinary system after PB insertion, mainly including renal hypo/dysplasia. The number of ureteric bud (UB) branches in the RikPB/PB embryonic kidney was significantly decreased in embryonic kidney culture. Only bone morphogenetic protein 4 (Bmp4), a key molecule regulating UB branching, is significantly downregulated in RikPB/PB embryonic kidney, while the expression levels of other molecules involved in the regulation of UB branching were not significantly different according to the RNA-sequencing (RNA-seq) data, and the results were verified by quantitative real-time polymerase chain reaction (RT-PCR) and immunofluorescence assays. Besides, the expression of pSmad1/5/8, a downstream molecule of BMP4 signaling, decreased by immunofluorescence. These findings suggest that abnormal expression of Rik may cause a reduction in the UB branches by reducing the expression levels of the UB branching-related molecule Bmp4, thus leading to the development of CAKUT.

ObjectivesAlanine aminotransferase (ALT) level is one of the crucial indexes to evaluate disease status for chronic hepatitis B (CHB) patients. However, whether the ALT level after nucleos(t)ide analog (NA) treatment is associated with hepatocellular carcinoma (HCC) development remains unclear.Materials and MethodsWe evaluated the association between ALT level and HCC occurrence in NA-treated patients and investigated the predictive value of ALT flare for HCC. The associations between ALT level and HCC were analyzed by logistic regression and Cox proportional hazards models.ResultsThere were 21,223 CHB patients at Ruijin Hospital of China and 16,737 CHB patients in the Optum electronic health records (EHR) in the United States (US) treated with NAs between 2010 and 2018. Among them, 8,152 and 4,893 patients who achieved a normal ALT value were included in the study cohorts, respectively. A significant positive dose-dependent correlation between the peak ALT level and HCC was identified in both cohorts. Within the China cohort, ALT flare was significantly associated with increased risks of HCC compared to normal ALT (HR 2.55, 95%CI 1.45–4.50). Stronger increased risks associated with ALT flare were observed in the US cohort (HR 7.62, 95%CI 4.85–11.98).ConclusionsALT flare is a strong predictor for HCC occurrence in the CHB patients treated with NAs. Elevation of ALT, especially ALT flare warrants close monitoring for early HCC detection.

Abstract Background Mutations in COQ8B (*615567) as a defect of coenzyme Q10 (CoQ10) cause steroid resistant nephrotic syndrome (SRNS). Methods To define the clinical course and prognosis of COQ8B nephropathy, we retrospectively assessed the genotype and phenotype in patients with COQ8B mutations from Chinese Children Genetic Kidney Disease Database. We performed the comparing study of renal outcome following CoQ10 treatment and renal transplantation between early genetic detection and delayed genetic detection group. Results We identified 20 (5.8%) patients with biallelic mutations of COQ8B screening for patients with SRNS, non‐nephrotic proteinuria, or chronic kidney disease (CKD) of unknown origin. Patients with COQ8B mutations showed a largely renal‐limited phenotype presenting with proteinuria and/or advanced CKD at the time of diagnosis. Renal biopsy uniformly showed focal segmental glomerulosclerosis. Proteinuria was decreased, whereas the renal function was preserved in five patients following CoQ10 administration combined with angiotensin‐converting enzyme (ACE) inhibitor. The renal survival analysis disclosed a significantly better outcome in early genetic detection group than in delayed genetic detection group (Kaplan–Meier plot and log rank test, p = .037). Seven patients underwent deceased donor renal transplantation without recurrence of proteinuria or graft failure. Blood pressure showed decreased significantly during 6 to 12 months post transplantation. Conclusions COQ8B mutations are one of the most common causes of adolescent‐onset proteinuria and/or CKD of unknown etiology in the Chinese children. Early detection of COQ8B nephropathy following CoQ10 supplementation combined with ACE inhibitor could slow the progression of renal dysfunction. Renal transplantation in patients with COQ8B nephropathy showed no recurrence of proteinuria.

Objective: Primary distal renal tubular acidosis (dRTA) is a rare genetic disease characterized by distal tubular dysfunction leading to metabolic acidosis and alkaline urine. Growth retardation is a major concern in these children. The disease is caused by defects in at least three genes (SLC4A1, ATP6V0A4, and ATP6V1B1) involved in urinary distal acidification. Several series of dRTA patients from different ethnic backgrounds have been genetically studied, but genetic studies regarding Chinese population is rare. Our aim was to investigate the clinical features and genetic basis of primary dRTA in Chinese children. Methods: Three unrelated patients with dRTA participated in our study. Next-generation sequencing was performed, and the findings were validated using the Sanger sequencing method. Results: All patients exhibited hyperchloraemic metabolic acidosis, abnormally high urine pH, hypokalemia, and nephrocalcinosis. Growth retardation was observed in all patients. During the follow-up (range 1–4 years), alkali replacement therapy corrected the systemic metabolic acidosis, and two patients demonstrated normal growth. rhGH therapy was administered to patient-3 at the age of 6 years, and his growth rate was significantly improved (growth velocity 9.6 cm/yr). In total, 5 mutations were identified in our cohort of three patients, and four mutations were novel. Conclusions: We report the clinical and molecular characteristics of dRTA patients from China. The four novel mutations detected in our study extend the spectrum of gene mutations associated with primary dRTA. Furthermore, our study confirms the effect of early treatment in improving growth for dRTA patient and provides insight into the effects of rhGH on dRTA patients who were diagnosed late and exhibiting a persistent growth delay despite appropriate therapy.

Automatic crankshaft production lines require high reliability and accuracy stability for the oscillating grinding machine. Crankshaft contour error represent the most intuitive data in production field selective inspection. If the mapping relation between the contour error components of the crankshaft pin journal and the axis position control error of the oscillating grinding machine can be found, it would be great significance for the reliability maintenance of the oscillating grinding machine. Firstly, a contour error decomposition method based on ensemble empirical mode decomposition (EEMD) is proposed. Secondly, according to the contour generating principle of the pin journal by oscillating grinding, a calculation method to obtain the effect of the axis position control error of the oscillating grinder on the contour error of the pin journal is proposed. Finally, through the grinding experiments, the error data are acquired and measured to calculate and decompose the contour error by using the proposed methods for obtaining the mapping relation between the crankshaft pin journal contour error and the axis position control error. The conclusions show that the proposed calculation and decomposition methods can obtain the mapping relation between the contour error components of the crankshaft pin journal and the axis position control error of the oscillating grinding machine, which can be used to predict the key functional component performance of the machine tool from the oscillating grinding workpiece contour error.

Objective: The aim of the study was to investigate the protective characteristic of chlorogenic acid, a natural glucosyl xanthone found in Lonicera Japonica on the cerebral ischemia reperfusion injury and the underlying mechanism. Methods: Focal cerebral ischemia reperfusion model was built by blocking the left middle cerebral artery in rats by using the suture-occluded method. Before operation, the corresponding drugs were given for each group once a day for 7 days. After 1 h of final administration, the model was built, after operation, reperfusion was conducted for 22 h, Before the reperfusion 10 min tail vein injection of large, medium and small dose of chlorogenic acid and then mortality was calculated, and Neurological deficit score (NDS) was conducted, and serum was collected to measure the NSE level; a 2 mm thick brain slice located at the intersection of optic nerves was collected for TTC staining, and the percentage of cerebral infarction area was calculated; brain homogenate was collected to measure the ICAM-1, VCAM-1, EPO and HIF-1α levels in brain tissue of cerebral ischemia reperfusion rat models; NGF was detected using immunohistochemical method; the morphological changes in brain tissue was observed with HE staining. Results: All focal cerebral ischemia reperfusion rat models were duplicated successfully. Every chlorogenic acid group with different dosage can significantly reduce the mortality, NDS and cerebral infarction area of rats, and significantly increase the EPO, HIF-1α and NGF levels in brain tissue; significantly improve the pathological lesions of hippocampus and cortex in brain tissue. Conclusion: The results showed that chlorogenic acid could protect the focal cerebral ischemia reperfusion injury rat models by adjusting the inflammatory factor, hypoxia factor and nerve growth factor. Keywords: Chlorogenic acid, Cerebral ischemia reperfusion, Animal model

Objective: To evaluate the effect of hyperuricemia (HU) on subclinical changes of left ventricle (LV) function and structure in patients with hypertension (HT) using three-dimensional speckle-tracking echocardiography (3DSTE) and to explore the relationships between serum uric acid (SUA) levels and three-dimensional speckle tracking echocardiography (3DSTE) parameters in hypertensive and nonhypertensive patients with HU. Methods: Four age- and sex-matched groups were studied: I: healthy controls, HT– HU– (n = 40); II: HT– HU+ (n = 40); III: HT+ HU– (n = 40); IV: HT+ HU+ (n = 44). Conventional echocardiography and 3DSTE were recorded. Relative wall thickness (RWT) and left ventricular mass index assessed by M-mode echocardiography (LVMi-M) were calculated. 3DSTE parameters including LV volumes and ejection fraction (EF), LVMi-3D, global longitudinal strain (GLS), and global circumferential strain (GCS) were compared. The relationships between SUA levels and 3DSTE parameters were investigated. Results: Despite LV diameters, LV volumes and EF were similar among groups (all p > 0.05), GLS decreased and LVMi-3D increased from controls (group I) to patients with HU or HT alone (group II or III), and patients with both HU and HT (group IV) (all p < 0.05). SUA levels were significantly correlated with the absolute value of GLS (r = −0.461, p < 0.05) and LVMi-3D (r = 0.504, p < 0.05) in hypertensive and nonhypertensive patients with HU. Conclusions: HU may exacerbate LV systolic dysfunction and remodeling in hypertensive patients, which can be detected by 3DSTE. Early uric acid lowing treatment may be beneficial for hypertensive patients with HU.

Background: It is highly recommended that all patients with coronary artery disease should be screened for depression. The Major Depression Inventory (MDI) is a widely used self-rating scale for the assessment of depression but is not valid in Chinese language. The present study was designed to assess the reliability and validity of a version of the MDI translated into Chinese among patients with acute myocardial infarction (AMI).Methods: Data were derived from the “Multicenter Delay in Patients Experiencing Acute Myocardial Infarction in Shanghai” (MEDEA FAR-EAST) study. Using a cross-sectional study design, the Chinese version of the MDI was administered to a total of 267 inpatients. The internal consistency reliability of the MDI scale was evaluated based on the Cronbach’s coefficient and the binary coefficient for the whole scale. Exploratory factor analysis was performed to assess the internal consistency of the MDI. To examine discriminant validity, we analyzed the correlation of the MDI score with the General Anxiety Disorder-7 (GAD-7) and World Health Organization-5 Well-Being Index (WHO-5) scale scores.Results: The Chinese version of the MDI showed high reliability (Cronbach’s alpha = 0.909, split-half reliability = 0.866). We identified one factor that explained 52% of the variance, which indicated that the MDI has satisfactory structural validity. The correlations of the MDI scores with the GAD-7 scores (r = 0.425) and the WHO-5 scores (r = −0.365) were moderate, suggesting that the MDI has acceptable discriminant validity.Conclusions: The MDI was proved to be a highly reliable and satisfactory valid diagnostic screening tool to assess depression in Chinese cardiac patients.

The effects of different heat treatments on abalones’ texture properties and sensory characteristics were studied. Thermal processing of abalone muscle was analyzed to determine the optimal heat treatment condition based on fuzzy evaluation. The results showed that heat treatment at 85°C for 1 hour had certain desirable effects on the properties of the abalone meat. Specifically, a back propagation (BP) neural network was introduced to predict the equations of statistically significant sensory hardness, springiness, and smell using the texture data gained through TPA (texture profile analysis) experiments as input and sensory evaluation data as the desired output. The final outcome was that the predictability was proved to be satisfactory, with an average error of 6.93%.

OBJETIVO: Determinar se três variantes (388 G>A, 521 T>C, 463 C>A) do membro 1B1 da família de transportadores de ânions orgânicos portadores de solutos (SLCO1B1) se associam à hiperbilirrubinemia neonatal. FONTE DE DADOS: Foi realizada busca na Infraestrutura do Conhecimento Nacional da China e em MEDLINE. A revisão sistemática com metanálise incluiu estudos genéticos que avaliaram a associação entre hiperbilirrubinemia neonatal e as variantes 388 G>A, 521 T>C, 463 C>A de SLCO1B1 entre janeiro de 1980 e dezembro de 2012. Foi realizada seleção e extração de dados por dois analistas, de forma independente. SUMÁRIO DOS ACHADOS: Foram incluídos dez artigos no estudo. Os resultados revelaram que SLCO1B1 388 G>A se associa a um aumento do risco de hiperbilirrubinemia neonatal (OR< 1,39; IC 95%: 1,07 a 1,82) em recém-nascidos chineses, mas não em recém-nascidos caucasianos, tailandeses, latino-americanos ou malaios. A mutação SLCO1B1 521 T>C mostrou baixo risco de hiperbilirrubinemia neonatal em recém-nascido chineses, e não foram encontradas associações importantes no Brasil nem em recém-nascidos caucasianos, asiáticos, tailandeses e malaios. Não houve diferenças significativas da SLCO1B1 463 C>A entre o grupo com hiperbilirrubinemia e o grupo controle. CONCLUSÃO: O estudo mostrou que a mutação 388 G>A do gene SLCO1B1 é fator de risco para desenvolver hiperbilirrubinemia neonatal em recém-nascidos chineses, mas não em populações caucasianas, tailandesas, brasileiras ou malaias; a mutação SLCO1B1 521 T>C fornece proteção de hiperbilirrubinemia neonatal em recém-nascidos chineses, mas não nas populações caucasianas, tailandesas, brasileiras ou malaias.

Objective: To determine whether three variants (388 G>A, 521 T>C, and 463 C>A) of the solute carrier organic anion transporter family member 1B1 (SLCO1B1) are associated with neonatal hyperbilirubinemia. Data source: The China National Knowledge Infrastructure and MEDLINE databases were searched. The systematic review with meta-analysis included genetic studies which assessed the association between neonatal hyperbilirubinemia and 388 G>A, 521 T>C, and 463 C>A variants of SLCO1B1 between January of 1980 and December of 2012. Data selection and extraction were performed independently by two reviewers. Summary of the findings: Ten articles were included in the study. The results revealed that SLCO1B1 388 G>A is associated with an increased risk of neonatal hyperbilirubinemia (OR, 1.39; 95% CI, 1.07–1.82) in Chinese neonates, but not in white, Thai, Latin American, or Malaysian neonates. The SLCO1B1 521 T>C mutation showed a low risk of neonatal hyperbilirubinemia in Chinese neonates, while no significant associations were found in Brazilian, white, Asian, Thai, and Malaysian neonates. There were no significant differences in SLCO1B1 463 C>A between the hyperbilirubinemia and the control group. Conclusion: This study demonstrated that the 388 G>A mutation of the SLCO1B1 gene is a risk factor for developing neonatal hyperbilirubinemia in Chinese neonates, but not in white, Thai, Brazilian, or Malaysian populations; the SLCO1B1 521 T>C mutation provides protection for neonatal hyperbilirubinemia in Chinese neonates, but not in white, Thai, Brazilian, or Malaysian populations.

Given the difficulty of treating schizophrenia and other forms of psychosis, researchers have shifted focus to early detection and intervention of individuals at clinical high risk (CHR) for psychosis. Previous studies have shown that elements in family functioning could predict symptom outcome in CHR individuals. However, associations between self reported family functioning and symptom or functioning outcome of CHR individuals was rarely reported. Our study aimed to investigate the characteristics and the role of family functioning in the development of CHR individuals among young adolescents.A sample of 32 CHR individuals was recruited from 2800 university students. The characteristics of family perception were evaluated by both Family Assessment Device (FAD) and Family cohesion and adaptability evaluation Scale II (FACES II). 6 month follow up data was available with 25 of the recruited CHR individuals. Baseline socio-demographic characteristics and family functioning were compared between CHR and control group. We also measured the associations between different dimensions of perceived family functioning and both severity of prodromal symptoms and global functioning at baseline and 6-month follow up.CHR individuals showed more maladaptive family functioning compared to control in nearly all of the dimensions of FAD and FACES II except for Affective Involvement. Better Problem Solving and Affective Responsiveness predicted less severe positive and negative symptoms respectively. Family cohesion and adaptability were not only correlated with the baseline severity of general symptoms, but also positively associated with the general and disorganized symptom outcome.This study contributed preliminary evidence towards the associations between family perception and symptom outcome of CHR individuals. It also provided evidence for the importance of family interventions on CHR individuals.

Compound controller which consists of CMAC network and PID network is mainly used in control system, especially in robot control. It can realize nonlinear tracking control of the real-time dynamic trajectory and possesses good approximation effect. According to the structure and principle of the compound controller, memristor is introduced to CMAC network to be a compound controller in this paper. The new PID controller based on memristive CMAC network is built up by replacing the synapse in the original controller by memristors. The effect of curve approximation is obtained by MATLAB simulation experiments. This network improves the response and learning speed of the system and processes better robustness and antidisturbance performance.