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BACKGROUND Although the imaging features of coronavirus disease 2019 (COVID-19) are starting to be well determined, what actually occurs within the bronchi is poorly known Here, we report the processes and findings of bronchoscopy in a patient with COVID-19 accompanied by respiratory failure CASE SUMMARY A 65-year-old male patient was admitted to the Hainan General Hospital on February 3, 2020 for fever and shortness of breath for 13 d that worsened for the last 2 d The severe acute respiratory syndrome coronavirus 2 nucleic acid test was positive Routine blood examination on February 28 showed a white blood cell count of 11 02 × 109/L, 86 9% of neutrophils, 6 4% of lymphocytes, absolute lymphocyte count of 0 71 × 109/L, procalcitonin of 2 260 ng/mL, and C-reactive protein of 142 61 mg/L Oxygen saturation was 46% at baseline and turned to 94% after ventilation The patient underwent video bronchoscopy The tracheal cartilage ring was clear, and no deformity was found in the lumen The trachea and bilateral bronchi were patent, while the mucosa was with slight hyperemia;no neoplasm or ulcer was found Moderate amounts of white gelatinous secretions were found in the dorsal segment of the left inferior lobe, and the bronchial lumen was patent after sputum aspiration The right inferior lobe was found with hyperemia and mucosal erosion, with white gelatinous secretion attachment The patient’s condition did not improve after the application of therapeutic bronchoscopy CONCLUSION For patients with COVID-19 and respiratory failure, bronchoscopy can be performed under mechanical ventilation to clarify the airway conditions Protection should be worn during the process Considering the risk of infection, it is not necessary to perform bronchoscopy in the mild to moderate COVID-19 patients © The Author(s) 2021 Published by Baishideng Publishing Group Inc All rights reserved

A critical pathogenic factor in the development of lethal liver failure is cell death induced by the accumulation of lipid reactive oxygen species. In this study, we discovered and illuminated a new mechanism that led to alcoholic liver disease via ferroptosis, an iron-dependent regulated cell death. Study in vitro showed that both necroptosis inhibitor and ferroptosis inhibitors performed significantly protective effect on alcohol-induced cell death, while apoptosis inhibitor and autophagy inhibitor had no such effect. Our data also indicated that alcohol caused the accumulation of lipid peroxides and the mRNA expression of prostaglandin-endoperoxide synthase 2, reduced the protein expression of the specific light-chain subunit of the cystine/glutamate antiporter and glutathione peroxidase 4. Importantly, ferrostatin-1 significantly ameliorated liver injury that was induced by overdosed alcohol both in vitro and in vivo. These findings highlight that targeting ferroptosis serves as a hepatoprotective strategy for alcoholic liver disease treatment.

A critical pathogenic factor in the development of lethal liver failure is cell death induced by the accumulation of lipid reactive oxygen species. In this study, we discovered and illuminated a new mechanism that led to alcoholic liver disease via ferroptosis, an iron-dependent regulated cell death. Study

Rationale Todd paralysis (a stroke-like presentation in some patients with epilepsy) caused by limbic encephalitis (LE) is not easily distinguished from acute ischemic stroke by clinicians in the emergency room. Patient concerns We report a contactin-associated protein-like 2-antibody (CASPR2-Ab)-positive patient who presented with atypical LE. Diagnoses CASPR2-Ab-positive LE was the presumed diagnosis. Re-evaluation of cerebrospinal fluid (CSF) samples revealed autoantibodies targeting CASPR2 at an immunoglobulin G titer of 1:1. The clinical presentation of subacute onset seizures, abnormal electroencephalography, hypermetabolism on positron emission tomography, good immunotherapy response, and the presence of specific antibodies in serum supports a diagnosis of autoimmune LE. Intervention The patient received glucocorticoids (1 g for 3 days and 500 mg for 3 days), immunoglobulin (25 g for 3 days), sodium valproate (1 g for 3 days), and clonazepam (1 mg for 3 days). Outcomes Remission of temporal lobe epilepsy symptoms and cognitive dysfunction was observed. Follow-up analysis of CSF and serological examination were not approved by the patient. His Mini-Mental State Examination score improved to 21/30. Stable remission of symptoms was achieved throughout the follow-up period of 50 days. Lessons Autoimmune encephalitis (AE) should be considered in cases of late-onset epilepsy following meningioma peritumoral brain edema and resection. A diagnosis of AE should be considered in patients presenting with stroke-like symptoms if the magnetic resonance imaging abnormality does not match a known vascular territory. Early and correct diagnosis is crucial because immunotherapy is usually effective for this disease.

OBJECTIVE: To study the protective effect of vitamin A on residual pancreatic β cell function in children with type 1 diabetes mellitus (T1DM) and its mechanism. METHODS: A total of 46 children with T1DM (with a course of disease of 0.5-1 year) were randomly divided into an intervention group and a non-intervention group (n=23 each). The children in both groups were given insulin treatment, and those in the intervention group were also given vitamin A at a daily dose of 1 500-2 000 IU. A total of 25 healthy children were enrolled as the control group. The daily dose of insulin was calculated for the children with T1DM, and the serum levels of glycosylated hemoglobin (HbA1C), stimulated C-peptide, vitamin A, and interleukin-17 (IL-17) were measured before intervention and 3 months after intervention. RESULTS: Before vitamin A intervention, the intervention group and the non-intervention group had a significantly lower serum level of vitamin A and a significantly higher level of IL-17 than the control group (P < 0.01). After 3 months of intervention, the intervention group had significantly lower serum IL-17 level and insulin dose and a significantly higher level of stimulated C-peptide than the non-intervention group (P < 0.05). CONCLUSIONS: Vitamin A may protect residual pancreatic β cell function, possibly by improving the abnormal secretion of IL-17 in children with T1DM.

The main contribution of this paper is to present a general design method of new nonlinear disturbance observer (NDO) based on tracking differentiator (TD) for uncertain dynamic system. The stability and convergence of the proposed NDO can be guaranteed by TD. This new NDO can be used to estimate many types of uncertain disturbances, and can overcome the disadvantages of existing NDOs that need the priori information concerning the upper and lower bounds of the disturbance and its ith derivative’s Lipschitz upper bound. It can be also applied in uncertain dynamic system for various purposes such as disturbance estimate and compensation, solving the problem of control input constraint, and reducing even eliminating chattering of control input. Simulation results are presented to show the effectiveness of the developed NDO.

Model validation and updating is critical to model credibility growth. In order to assess model credibility quantitatively and locate model error precisely, a new dynamic validation method based on extremum field mean mode decomposition (EMMD) and the Prony method is proposed in this paper. Firstly, complex dynamic responses from models and real systems are processed into stationary components by EMMD. These components always have definite physical meanings which can be the evidence about rough model error location. Secondly, the Prony method is applied to identify the features of each EMMD component. Amplitude similarity, frequency similarity, damping similarity and phase similarity are defined to describe the similarity of dynamic responses. Then quantitative validation metrics are obtained based on the improved entropy weight and energy proportion. Precise model error location is realized based on the physical meanings of these features. The application of this method in aircraft controller design provides evidence about its feasibility and usability.

This paper presents a study on the different applying methods of (NH4)2HPO4 fire retardant influence on physical and mechanical properties of bamboo scrimber. The results showed: the properties of bamboo scrimber would change with applying methods changing of fire retardant; the method of applying fire retardants before gluing would increase the part of physical and mechanical properties of bamboo scrimber, but it would increase the manufacturing cost of bamboo scrimber; the method of applying fire retardants after gluing would reduce the part of physical and mechanical properties of bamboo scrimber.

Extraction of citric acid from aqueous solutions with tertiary amine, dissolved in mixtures of kerosene and phase modifier have been studied as a function of exaction yield at different phase modifier volume fraction, temperatures, stirring speed and exaction time. The optimal experimental conditions of extraction were obtained: reaction temperature 303K, reaction time 3 min, the kerosene volume fraction 20%, and 45% 1−octanol as phase modifier, stirring speed 450rpm/min. Under these conditions, the extraction yield could reach 75%. The complex of citric acid and tertiary amine was a surfactant that makes surface tension decrease. The composition of the citric acid complex is (R3N) · (H3A). The formation of complex was exothermic reaction that the standard enthalpy change and standard entropy change are obtained: ΔHθ=-10.17kJ/mol, ΔSθ=-11.86J/(mol·K).

The technology of infrared wireless communication offers us a wireless connection and communication mode that is low cost, high speed and short distance. IrDA infrared data association brings forward IrDA infrared communication protocol that is the base of a large number of equipments, interlink with infrared data interface. This paper introduces IrDA standard and the frame structure of IrDA standard. An improve analysis is presented linking processor of IrLAP.

The efficiency of coal combustion is an important factor for the blast furnace process. The influence of low xo/xc on coal combustion performance under nitrogen free blast furnace condition was researched through the self-developed pulverized coal burning device. The results show that the coal combustion rate reduces with xo/xc decreasing, and the combustion rate of bituminous coal is higher than that of anthracite. The coal combustion rate ascends with the rise of volatile matter, but when volatile matter of pulverized coal is more than 18%, the combustion rates will not increase correspondingly. Small amount of CaCO3 and CO2 additions can promote coal combustion, and the effect of CaCO3 is more apparent, which can increase the pulverized coal combustion rate by 15%–18% or so.

The objective of the present investigation is to analyze the influence of profile of blast furnace on the burden motion and stress field through 3D-DEM (three-dimensional discrete element method). It is clarified that the decrease of shaft angle speeds up the velocity of burden descending and decreases normal stress between particles or particle and wall. This change is good for the smooth operation of blast furnace. However, ore and coke would be mixed for the too small shaft angle (75°), which would influence the permeability in blast furnace. Thus, the appropriate shaft angle is around 80°. Decrease of bosh angle prevents the burden descending motion and increases normal stress between particles and bosh wall. Meanwhile, maximum normal stress acting on the wall moves from belly wall to bosh wall in the case of 68° bosh angle, which accelerates abrasion of refractory in bosh by friction force between particles and wall. Although burden descends smoothly in the case of 88° bosh angle, room is not enough for the ascending heated gas flow. Thus, the appropriate bosh angle is about 78°.

To evaluate the current status of penis and testicular development in boys and the effects of overweight/obesity on their development in the Zhengzhou area of Henan Province.Height, weight, waist circumference, hip circumference, penis length and testicular volume were measured in 3 546 4 to 12-year-old boys. The penis length and testicular volume were compared between the overweight/obesity and normal weight groups.Before 9 years of age, the testicular volume was progressively smaller, and after 9 years old, it gradually increased. By the age of 11, it increased rapidly. The penis length increased gradually between 4 and 11 years of age, and after the age of 11 it increased rapidly. Phimosis was found in 144 cases (4.01%) and cryptorchidism was found in 18 cases (0.51%). A total of 639 (18.02%) boys were overweight or obese among 3 546 boys. At the ages of 6 and 7 years, the testicular volume in the overweight/obesity group was greater than in the normal control group (P0.05). The penis length in the overweight/obesity group was significantly shorter than in the normal control group (P0.05) by the age of 11 years. The correlation analysis showed that the testicular volume at the ages of 4 and 5 years was positively correlated with height, weight, BMI, waist circumference and hip circumference in overweight/obese boys. The penis length at the ages of 7 and 8 years was negatively correlated with weight, waist circumference and hip circumference. By the age of 12 years, the penis length was positively correlated with the height.The development of penis and testicles in boys in the Zhengzhou area is in line with the level of sex development of Chinese boys. Overweight/obesity adversely affects the development of penis and testicles.

OBJECTIVE: This study aimed to investigate the influence of low-dose levodopa (L-DOPA) on neuronal cell death under oxidative stress. METHODS: PC12 cells were treated with L-DOPA at different concentrations. We detected the L-DOPA induced reactive oxygen species (ROS). Meanwhile, MTT and LDH assay were performed to determine the proliferation and growth of PC12 cells with or without ROS scavenger. In addition, after pretreatment with L-DOPA at different concentrations alone or in combination with CD39 inhibitor, PC12 cells were incubated with hydrogen peroxide (H2O2) and the cell viability was evaluated by MTT and LDH assay. In addition, the expression of pCREB and CD39 was detected by immunofluorescence staining and Western blot assay in both cells and rat's brain after L-DOPA treatment. RESULTS: After treatment with L-DOPA for 3 days, the cell proliferation and growth were promoted when the L-DOPA concentration was 30 µM. Low dose L-DOPA could protect the PC12 cells from H2O2 induced oxidative stress, which was compromised by CD39 inhibitor. In addition, the expression of CD39 and pCREB increased in both PC12 cells and rats' brain after L-DOPA treatment. CONCLUSIONS: L-DOPA at different concentrations has distinct influence on proliferation and growth of PC12 cells, and low dose (

To obtain Ammonia and greenhouse gas (GHG) emission factors of caged broilers, ammonia (NH3), methane (CH4), nitrous oxide (N2O) and carbon dioxide (CO2) emissions of broilers aged 0 d to 42 days were monitored in caged broilers production systems located in Shandong province. Gas concentrations of incoming and exhaust air streams were measured by using INNOVA 1312 multi-gas monitor with multi-channel samplers. Building ventilation rates were determined by on site FANS (Fan Assessment Numeration System) measurement systems. The NH3 emission factors showed a trend of increase at the beginning and then decreased with the broiler ages. The NH3 emission rates were 8.5 to 342.1 mg x (d x bird)(-1) and the average daily emission rate was 137.9 mg x (d x bird)(-1) [48.6 g x (d x AU)(-1)] over the 42-d period. The GHGs emission rates were 19.5-351.9 mg x (d x bird)(-1) with an average of 154.5 mg x (d x bird)(-1) [54.4 g x (d x AU)(-1)] for CH4, and 2.2- 152.9 g x (d x bird)(-10 with an average of 65.9 g x (d x bird)(-1) [23.2 kg x (d x AU)(-1)] for CO2. No emission of N2O was observed. The CH4 and CO2 emission rates increased with the increase of broilers ages. The total NH3 emission over the 42 d growing period averaged (5.65 +/- 1.02) g x (bird x life cycle)(-1). The NH3 emission contribution in different growth phase to the total emission were 33.6% in growth phase 1 (0-17 day, GP1), 36.4% in GP2 (18-27 days), and 29.9% in GP3 (28-42 days), respectively. The NH3 emission in GP2 was significantly higher than emission in GP1 and GP3. CH4 and CO2 cumulative emission rates were (6.30 +/- 0.16) g x (bird(-1) x life cycle)(-1) and (2.68 +/- 0.18) kg x (bird x life cycle)(-1), respectively. The cumulative emission rates of CH4 and CO2 in GP3 were significantly higher than emission rates in GP2 and in GP1, accounting for 50% of total emissions. The results of this study could provide the data support for mitigation of gas emission from broilers production.

To evaluate the association of cytotoxic T lymphocyte-associated antigen-4 (CTLA-4) + 49A/G polymorphism with type 1 diabetes mellitus (T1DM) in children.Papers about the association of CTLA4+49A/G polymorphism with T1DM in children were collected by searching PubMed, EBSCO, CBM, CNKI, and Wanfang Data. A meta-analysis was performed to examine differences in the genotypes (AG, GG, and GG+AG) and G allele at position 49 of the CTLA-4 gene between a childhood T1DM group and a control group.A total of 10 papers involving 1084 T1DM children and 1338 healthy children were included. The Meta-analysis was performed to evaluate the association of the genotypes (AG, GG, and GG+AG) and the G allele at position 49 of the CTLA-4 gene with T1DM using a fixed effect model according to the heterogeneity test results of all studies. The pooled OR values (95% CI) were 1.13 (0.97-1.33), 1.42 (1.16-1.75), 1.20 (1.03-1.40), and 1.21 (1.09-1.33), suggesting a significant difference in genotypes (AG, GG, and GG+AG) and the G allele at position 49 of the CTLA-4 gene between the two groups.CTLA-4 +49A/G polymorphism is associated with T1DM in children.

The objective of this study was to compare the effects of diets rich in either cornstalk silage or dry cornstalk of different concentrate-to-forage ratios on the methane production of sheep over a period of ten months. A total of fifty-nine sheep were randomly divided into four groups and fed to cornstalk silage and dry cornstalk diet at 40% and 20% concentrate level. The methane production was analysed using the sulphur hexafluoride (SF6) tracer gas technique. The ruminal fluid was analysed for pH, VFA and ammonia-N concentrations. Based on the 40% or 20% concentrate proportion, the sheep fed the cornstalk silage exhibited a lower methane production (28.13 vs. 31.97 L/d or 28.41 vs. 33.9 L/d) and lower methane emissions per kg of DMI (33.96 vs. 35.35 g/kg or 35.38 vs. 40.43 g/kg) than the sheep fed the dry cornstalk. Furthermore, the sheep fed the cornstalk silage also displayed lower gross energy losses as methane (8.27 vs. 8.57% or 8.69 vs. 10.42%) than the sheep fed the dry cornstalk. For the rumen fluid analysis, the acetic-to-propionic acid proportion tended to decrease for the sheep fed the cornstalk silage when compared with that of the sheep fed the dry cornstalk. Cornstalk silage added to the diet had the effect of reducing the methane emissions from sheep, but the mitigating effect of the silage was influenced by the concentrate-to-forage ratio, the effect of adding the cornstalk silage was significant when the amount of concentrate was set at a low level.

The traditional network drawing method is limited to artificial drawing and artificial experience etc. Aimed at these problems exist in construction schedule management, network planning software is the key to improve the design efficiency and management of the project. In this research, the principle of network planning technique, drawing methods of bar chart and network graph, the characteristics of bar plan and network plan and the calculation of network plan time parameters were introduced. Taking the South-to-North Water Diversion Project in Tianjin Segment as an example, the network chart was drawn. The finished network chart provided a scientific and effective method for the management and decision-making associated with the construction. The network planning programming in Interbasin Water Transfer Project is of characteristics of system, controllability and dynamic.

To explore the effects of Astragalus membranaceus (AM) on the cytokines secretion of peripheral dendritic cells (DC), including interleukin-10, -12, and -18 (IL-10, IL-12 and IL-18), in children with Henoch-Schonlein purpura (HSP) in the acute phase; and to study the immunological regulation mechanism of AM.Peripheral blood mononuclear cells (PBMC) were obtained from 28 children with acute HSP by density gradient centrifugation, and each sample was divided into two parts, one untreated and one treated with AM. All cells were developed to mature DC through treating with recombinant human granulocyte macrophage colony stimulating factor (GM-CSF), interleukin-4 (IL-4) and tumor necrosis factor-alpha (TNF-alpha). Expression of CD83 in the surface of mature DC was detected by flow cytometry, and levels of IL-10, IL-12 and IL-18 in the supernatant were measured by ELISA.The supernatant level of IL-12 was higher [(141.58 +/- 100.19) ng/L vs (96.18 +/- 76.65) ng/L, t = 3.90, P0.01], while levels of IL-10 and IL-18 were lower (t = 2.70, P0.05; t = 4.07, P0.01) in AM treated PBMCs than those in the untreated ones.AM can correct the immunologic dysfunction of HSP children through increasing the IL-12, and decreasing the IL-10 and IL-18 secretions of PBMCs.

A high level of plasma homocysteine (Hcy) increases the risk for neurodegenerative diseases. One such disorder is Alzheimer's disease, which involves marked neuronal apoptosis of unknown etiology. This study shows that Hcy inhibits expression of 14-3-3ε and activates calcineurin in rat hippocampal neurons in a dose-dependent manner. Calcineurin-mediated Bad dephosphorylation, which is blocked by calcineurin inhibition and Ca(2+) chelation, causes mitochondrial translocation of Bad and apoptosis; this step in the apoptotic pathway is synergistically blocked by calcineurin inhibition and overexpression of 14-3-3ε. These findings demonstrated that calcineurin activation and downregulation of 14-3-3ε may be one of the mechanisms of Hcy-induced apoptosis of hippocampal neurons.