Double filtration plasmapheresis for children with different types of critical kidney diseases: a single-center retrospective cohort study

Background

Double filtration plasmapheresis (DFPP) was initially used to facilitate the conduction of ABO-incompatible renal transplantation. The applicability of DFPP has recently expanded to cover the removal of various antibodies in adults with immune-mediated diseases. However, DFPP is seldom used in children, with few reports addressing its efficacy and safety in this population. This study aimed to explore the efficacy and adverse effects of DFPP for pediatric patients with renal indications.

Methods

Children who received DFPP between December 2017 and December 2020 at Tongji Hospital were retrospectively studied, and sub-grouped for analysis according to the types of disease. All children received 3 to 6 DFPP sessions within 2 to 3 weeks, and were assessed for clinical outcomes according to glomerular filtration rate, proteinuria and extra-renal symptoms. Pre- and post-DFPP plasma were collected to measure the levels of pathogenic autoantibodies, immunoglobulins, fibrinogen, albumin, calcium, etc. In-hospital complications were also recorded.

Results

Totally there were 10 children receiving 44 sessions of DFPP, including 2 males and 8 females, with a median age of 11.2 years old (5-13 years) and a median weight of 42.1 kg (20-59 kg). Five patients were treated for systemic lupus erythematosus (SLE), three patients for antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV), one for C3 glomerulopathy and one for ABO-incompatible renal transplantation. Plasma autoantibodies decreased substantially by 93% and 89% in those with SLE and AAV after the last session, respectively. Complete or partial responses were achieved in 80%, 33.3%, 100% and 100% of patients with SLE, AAV, C3 glomerulopathy, and ABO-incompatible renal transplantation, respectively. The proportion of cumulative IgG, fibrinogen, and albumin removal at the end of the last sessions were 58.8%, 67.69%, and 14.05% respectively. The removal of calcium, potassium and creatinine were not statistically significant. A few episodes (4.55%) of hypotension were observed when fresh frozen plasma was used as the replacement fluid, and no bleeding nor severe anaphylaxis was noted.

Conclusions

The efficacy and safety of DFPP treatment in children with SLE, AAV, C3 glomerulopathy and ABO-incompatible renal transplantation were described in the present study. DFPP is proven to be a safe apheresis method for children weighing more than 20 kg.

Expression profile and prognostic values of GATA family members in kidney renal clear cell carcinoma

To investigate the possible diagnostic and prognostic biomarkers of kidney renal clear cell carcinoma (KIRC), an integrated study of accumulated data was conducted to obtain more reliable information and more feasible measures. Using the Tumor Immune Estimation Resource (TIMER), University of Alabama at Birmingham Cancer Data Analysis Portal (UALCAN), Human Protein Atlas (HPA), Kaplan-Meier plotter database, Gene Expression Profiling Interactive Analysis (GEPIA2) database, cBioPortal, and Metascape, we analyzed the expression profiles and prognoses of six members of the GATA family in patients with KIRC. Compared to normal samples, KIRC samples showed significantly lower GATA2/3/6 mRNA and protein expression levels. KIRC's pathological grades, clinical stages, and lymph node metastases were closely related to GATA2 and GATA5 levels. Patients with KIRC and high GATA2 and GATA5 expression had better overall survival (OS) and recurrence-free survival (RFS), while those with higher expression of GATA3/4/6 had worse outcomes. The role and underlying mechanisms of the GATA family in cell cycle, cell proliferation, metabolic processes, and other aspects were evaluated based on Kyoto Encyclopedia of Genes and Genomes (KEGG) and Gene Ontology (GO) enrichment analyses. Furthermore, we found that infiltrating immune cells were highly correlated with GATA expression profiles. These results showed that GATA family members may serve as prognostic biomarkers and therapeutic targets for KIRC.

Longitudinal relation between maladaptive parenting and nonsuicidal self-injury among Chinese early adolescents: The roles of internalizing symptoms and FKBP5 gene variation

BACKGROUND

While increasing research has effectively documented that maladaptive parenting is a significant risk factor for adolescent nonsuicidal self-injury, the process mechanism and gene-by-environment interaction in this relation among Chinese early adolescents are still poorly understood.

METHODS

In this study, a multi-informant longitudinal design was applied to investigate the indirect effect of internalizing symptoms in the relation between maladaptive parenting and nonsuicidal self-injury, and to examine how FKBP5 gene variation moderates these association. A total of 1718 Chinese Han early adolescents (44.30 % girls; M_age at Wave 1 = 10.35) and their parents participated this study.

RESULTS

The results showed that maladaptive parenting significantly predicts adolescent nonsuicidal self-injury after six months. Maladaptive parenting was also indirectly related to nonsuicidal self-injury via internalizing symptoms. Moreover, using a cumulative genetic score approach, the results showed that FKBP5 gene variation moderates the predictive effect of maladaptive parenting on internalizing symptoms and also moderates the indirect effect of internalizing symptoms between maladaptive parenting and nonsuicidal self-injury. These effects were more salient among adolescents with high (versus low) FKBP5 gene related cumulative genetic score linked to heightened stress reactivity.

LIMITATIONS

Our study only obtained two waves of data. Three waves of data would be more suitable for examining a mediation model.

CONCLUSION

This study reveals the process mechanism between maladaptive parenting and nonsuicidal self-injury and highlights the significance of gene-by-environment interaction to explain the emergence of nonsuicidal self-injury among adolescents.

Soft Electronics for Health Monitoring Assisted by Machine Learning

Due to the development of the novel materials, the past two decades have witnessed the rapid advances of soft electronics. The soft electronics have huge potential in the physical sign monitoring and health care. One of the important advantages of soft electronics is forming good interface with skin, which can increase the user scale and improve the signal quality. Therefore, it is easy to build the specific dataset, which is important to improve the performance of machine learning algorithm. At the same time, with the assistance of machine learning algorithm, the soft electronics have become more and more intelligent to realize real-time analysis and diagnosis. The soft electronics and machining learning algorithms complement each other very well. It is indubitable that the soft electronics will bring us to a healthier and more intelligent world in the near future. Therefore, in this review, we will give a careful introduction about the new soft material, physiological signal detected by soft devices, and the soft devices assisted by machine learning algorithm. Some soft materials will be discussed such as two-dimensional material, carbon nanotube, nanowire, nanomesh, and hydrogel. Then, soft sensors will be discussed according to the physiological signal types (pulse, respiration, human motion, intraocular pressure, phonation, etc.). After that, the soft electronics assisted by various algorithms will be reviewed, including some classical algorithms and powerful neural network algorithms. Especially, the soft device assisted by neural network will be introduced carefully. Finally, the outlook, challenge, and conclusion of soft system powered by machine learning algorithm will be discussed.

[Serological characteristics and molecular mechanism of an individual with p phenotype]

OBJECTIVE

To analyze the serological characteristics and molecular mechanism for an individual with p phenotype.

METHODS

An individual with p phenotype upon blood group identification at Jiaxing Blood Center in May 2021 was analyzed. ABO, RhD and P1PK blood groups and irregular antibodies in her serum were identified using conventional serological methods. The encoding region of α1, 4-galactosyltransferase gene (A4GALT) encoding P1 and Pk antigens was analyzed by polymerase chain reaction-sequence-based typing (PCR-SBT).

RESULTS

The individual was A group, RhD positive and had a p phenotype of the P1PK blood group system. Anti-PP1Pk was discovered in her serum. Sequencing analysis revealed that she has harbored a homozygous c.343A>T variant of the A4GALT gene.

CONCLUSION

The homozygous c.343A>T variant of the A4GALT gene probably underlay the p phenotype in this individual.

Cation-free siRNA-cored nanocapsules for tumor-targeted RNAi therapy

Cation-associated cytotoxicity limits the systemic administration of RNA delivery in vivo, demanding the development of non-cationic nanosystems. In this study, cation-free polymer-siRNA nanocapsules with disulfide-crosslinked interlayer, namely T-SS(-), were prepared via the following steps: 1) complexation of siRNA with a cationic block polymer cRGD-poly(ethylene glycol)-b-poly[(2-aminoethanethiol)aspartamide]-b-poly{N'-[N-(2-aminoethyl)-2-ethylimino-1-aminomethyl]aspartamide}, abbreviated as cRGD-PEG-PAsp(MEA)-PAsp(C=N-DETA), 2) interlayer crosslinking via disulfide bond in pH 7.4 solution, and 3) removal of cationic DETA pendant at pH 5.0 via breakage of imide bond. The cationic-free nanocapsules with siRNA cores not only showed great performance (such as efficient siRNA encapsulation, high stability in serum, cancer cell targeting via cRGD modification, and GSH-triggered siRNA release), but also achieved tumor-targeted gene silencing in vivo. Moreover, the nanocapsules loaded with siRNA against polo-like kinase 1 (siRNA-PLK1) significantly inhibited tumor growth without showing cation-associated toxicity side effects and remarkably improved the survival rate of PC-3 tumor-bearing mice. The cation-free nanocapsules could potentially serve as a safe and effective platform for siRNA delivery. STATEMENT OF SIGNIFICANCE: Cation-associated toxicity limits the clinical translation of cationic carriers for siRNA delivery. Recently, several non-cationic carriers, such as siRNA micelles, DNA-based nanogels, and bottlebrush-architectured poly(ethylene glycol), have been developed to deliver siRNA. However, in these designs, siRNA as a hydrophilic macromolecule was attached to the nanoparticle surface instead of being encapsulated. Thus, it was easily degraded by serum nuclease and often induced immunogenicity. Herein, we demonstrate a new type of cation-free siRNA-cored polymeric nanocapsules. The developed nanocapsules not only showed capacities including efficient siRNA encapsulation, high stability in serum, and cancer cell targeting via cRGD modification, but also achieved an efficient tumor-targeted gene silencing in vivo. Importantly, unlike cationic carriers, the nanocapsules exhibited no cation-associated side effects.

Ultrasound-guided core needle biopsy for accessing laryngeal masses with unsatisfactory laryngoscopy and biopsy results

BACKGROUND

Laryngoscopy and biopsy is the standard techniques to sample and diagnose laryngeal neoplasms, but not all patients with laryngeal neoplasm are eligible for biopsy via laryngoscopy (e.g., submucosal neoplasms).

PURPOSE

This study was conducted to evaluate the feasibility and diagnostic yield of ultrasound-guided core needle biopsy (US-CNB) for submucosal laryngeal neoplasms with unsatisfactory laryngoscopy and biopsy results.

METHODS

We retrospectively reviewed the medical records of 24 patients with unsatisfactory laryngoscopy and biopsy results who were referred to our center for US-CNB from January 2017 to November 2021. For all enrolled patients, we assessed consistency between the laryngoscopic biopsy, US-CNB, and final results. The final results were determined from the surgical biopsy results or clinical follow-up information (at least 3 month). Differences between biopsy techniques were compared using the Fisher's exact test. A P value less than 0.05 indicated statistical significance.

RESULTS

Twenty-four patients (median [range] age: 60.6 [41-76] years, 20 men) were included in our study. Among the 24 patients, 12 were eligible for laryngoscopic biopsy. In total, 24 patients underwent 26 US-CNB. Two patients underwent a repeat US-CNB for conformation of a benign histological result or due to inadequate specimen collection. The results of laryngoscopic biopsy and US-CNB were compared with the final result. The overall accuracy of US-CNB for differentiating benign from malignant lesions was 95.8 % (23/24), and this procedure had a sensitivity, specificity, positive predictive value, and negative predictive value of 95.2 %, 100 %, 100 %, and 75 %, respectively. The results of US-CNB are significantly better than those of laryngoscopic biopsy.

CONCLUSIONS

US-CNB is a safe, effective, and feasible technique for investigating suspicious submucosal laryngeal neoplasms and can serve as a complementary method for early and timely diagnosis of those neoplasms.

[Association of greenness exposure with waist circumference and central obesity in Chinese adults aged 65 years and over]

Objective: To examine the association of greenness exposure with waist circumference (WC) and central obesity in older adults in China. Methods: Based on the cross-sectional data from the Chinese Longitudinal Healthy Longevity Survey in 2017-2018, 14 056 participants aged 65 years and over were included. Demographic characteristics, lifestyle, WC, and other information were collected through a questionnaire and physical examination. Based on the satellite monitoring data of moderate-resolution imaging spectroradiometer (MODIS) provided by NASA, the annual mean of normalized difference vegetation index (NDVI) within a radius of 1 000 meters was obtained as the measurement value of greenness exposure. Multivariate linear regression model, multivariate logistic regression model, and restricted cubic splines (RCS) model were used to analyze the association and dose-response relationship between greenness exposure and WC and central obesity in older adults in China. Results: A total of 14 056 participants were enrolled with a median age of 84.0 years [IQR: 75.0-94.0 years]. About 45.0% (6 330) of them were male and 48.6% (5 853) were illiterate. There were 10 964 (78.0%) participants from rural. The mean of WC was (84.4±10.8) cm. Central obesity accounted for 60.2% (8 465), and the NDVI range was (-0.06, 0.78). After adjusting for confounding factors, the multivariate linear regression model showed that the change value of WC in the urban group [β (95%CI):-0.49 (-0.93, -0.06)] was smaller than that in the rural [-0.78 (-0.98, -0.58)] for every 0.1 unit increase in NDVI (Pinteraction=0.022). Compared with the Q1 group in NDVI, WC of Q2 and Q3 groups in rural decreased, and the β (95%CI) values were-1.74 (-2.5, -0.98) and-2.78 (-3.55, -2.00), respectively. The multivariate logistic regression model showed that after adjusting for confounding factors, the risk of central obesity decreased for urban and rural older adults with an increase of 0.1 unit in NDVI, and the OR (95%CI) values were 0.87 (0.80, 0.95) and 0.86 (0.82, 0.89), respectively (Pinteraction=0.284). Compared with the Q1 group in NDVI, the risk of central obesity in the Q2 and Q3 groups in rural was lower, and the OR (95%CI) values were 0.68 (0.58, 0.80) and 0.57 (0.49, 0.68), respectively. The results of the multivariate regression model with RCS showed that there was a non-linear association of NDVI with WC (Pnonlinear=0.006) and central obesity (Pnonlinear=0.025). Conclusion: Greenness exposure is negatively associated with WC and central obesity in older adults in China.

One-step fabrication of three-dimensional macropore copolymer-modified polycarbonate array by photo-crosslinking for protein immunoassay

A photocross-linked copolymer was prepared, and could rapidly form a macropore structure in phosphate buffer solution (PBS) without the addition of porogen. The photo-crosslinking process contained the crosslinking of the copolymer itself and that with the polycarbonate substrate. The three-dimensional (3D) surface was achieved through one-step photo-crosslinking of the macropore structure. The macropore structure can be finely regulated by multiple dimensions, including monomer structure of the copolymer, PBS and copolymer concentration. Compared with the two-dimensional (2D) surface, the 3D surface has a controllable structure, a high loading capacity (59 μg cm^-2) and immobilization efficiency (92%), and the effect of inhibiting the coffee ring for protein immobilization. Immunoassay results show that a 3D surface immobilized by IgG has high sensitivity (LOD value of 5 ng mL^-1) and broader dynamic range (0.005-50 μg mL^-1). This simple and structure-controllable method for preparing 3D surfaces modified by macropore polymer has great potential applications in the fields of biochips and biosensing.

Using ultrasound radiomics analysis to diagnose cervical lymph node metastasis in patients with nasopharyngeal carcinoma

OBJECTIVE

This study aimed to explore the clinical value of ultrasound radiomics analysis in the diagnosis of cervical lymph node metastasis (CLNM) in patients with nasopharyngeal carcinoma (NPC).

METHODS

A total of 205 cases of NPC CLNM and 284 cases of benign lymphadenopathy with pathologic diagnosis were retrospectively included. Grayscale ultrasound (US) images of the largest section of every lymph node underwent feature extraction. Feature selection was done by maximum relevance minimum redundancy (mRMR) algorithm and multivariate logistic least absolute shrinkage and selection operator (LASSO) regression. Logistic regression models were developed based on clinical features, radiomics features, and the combination of those features. The AUCs of models were analyzed by DeLong's test.

RESULTS

In the clinical model, lymph nodes in the upper neck, larger long axis, and unclear hilus were significant factors for CLNM (p < 0.001). MRMR and LASSO regression selected 7 significant features for the radiomics model from the 386 radiomics features extracted. In the validation dataset, the AUC value was 0.838 (0.776-0.901) in the clinical model, 0.810 (0.739-0.881) in the radiomics model, and 0.880 (0.826-0.933) in the combined model. There was not a significant difference between the AUCs of clinical models and radiomics models in both datasets. DeLong's test revealed a significantly larger AUC in the combined model than in the clinical model in both training (p = 0.049) and validation datasets (p = 0.027).

CONCLUSION

Ultrasound radiomics analysis has potential value in screening meaningful ultrasound features and improving the diagnostic efficiency of ultrasound in CLNM of patients with NPC.

KEY POINTS

• Radiomics analysis of gray-scale ultrasound images can be used to develop an effective radiomics model for the diagnosis of cervical lymph node metastasis in nasopharyngeal carcinoma patients. • Radiomics model combined with general ultrasound features performed better than the clinical model in differentiating cervical lymph node metastases from benign lymphadenopathy.

Microbial dysbiosis in oral squamous cell carcinoma: A systematic review and meta-analysis

Objective

The aim of this study was to summarize previously published data and assess the alterations in the composition of the oral microbiome in OSCC using a systematic review and meta-analysis.

Design

Electronic databases were systematically searched for studies on the oral microbiome in OSCC published before December 2021. Qualitative assessments of compositional variations at the phylum level were performed. The meta-analysis on abundance changes of bacteria genera was performed via a random-effects model.

Results

A total of 18 studies involving 1056 participants were included. They consisted of two categories of studies: 1) case-control studies (n = 9); 2) nine studies that compared the oral microbiome between cancerous tissues and paired paracancerous tissues. At the phylum level, enrichment of Fusobacteria but depletion in Actinobacteria and Firmicutes in the oral microbiome was demonstrated in both categories of studies. At the genus level, Fusobacterium showed an increased abundance in OSCC patients (SMD = 0.65, 95% CI: 0.43-0.87, Z = 5.809, P = 0.000) and in cancerous tissues (SMD = 0.54, 95% CI: 0.36-0.72, Z = 5.785, P = 0.000). The abundance of Streptococcus was decreased in OSCC (SMD = -0.46, 95% CI: -0.88-0.04, Z = -2.146, P = 0.032) and in cancerous tissues (SMD = -0.45, 95% CI: -0.78-0.13, Z = -2.726, P = 0.006).

Conclusions

Disturbances in the interactions between enriched Fusobacterium and depleted Streptococcus may participate in or prompt the occurrence and development of OSCC and could be potential biomarkers for detection of OSCC.

Rapid and Sensitive Diagnosis of COVID-19 Using an Electricity-Free Self-Testing System

Rapid and sensitive detection of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is essential for early diagnosis and effective treatment. Nucleic acid testing has been considered the gold standard method for the diagnosis of COVID-19 for its high sensitivity and specificity. However, the polymerase chain reaction (PCR)-based method in the central lab requires expensive equipment and well-trained personnel, which makes it difficult to be used in resource-limited settings. It highlights the need for a sensitive and simple assay that allows potential patients to detect SARS-CoV-2 by themselves. Here, we developed an electricity-free self-testing system based on reverse transcription loop-mediated isothermal amplification (RT-LAMP) that allows for rapid and accurate detection of SARS-CoV-2. Our system employs a heating bag as the heat source, and a 3D-printed box filled with phase change material (PCM) that successfully regulates the temperature for the RT-LAMP. The colorimetric method could be completed in 40 min and the results could be read out by the naked eye. A ratiometric measurement for exact readout was also incorporated to improve the detection accuracy of the system. This self-testing system is a promising tool for point-of-care testing (POCT) that enables rapid and sensitive diagnosis of SARS-CoV-2 in the real world and will improve the current COVID-19 screening efforts for control and mitigation of the pandemic.

PddCas: A Polydisperse Droplet Digital CRISPR/Cas-Based Assay for the Rapid and Ultrasensitive Amplification-Free Detection of Viral DNA/RNA

Clustered regularly interspaced short palindromic repeats (CRISPR)-based assays have been an emerging diagnostic technology for pathogen diagnosis. In this work, we developed a polydisperse droplet digital CRISPR-Cas-based assay (PddCas) for the rapid and ultrasensitive amplification-free detection of viral DNA/RNA with minimum instruments. LbaCas12a and LbuCas13a were used for the direct detection of viral DNA and RNA, respectively. The reaction mixtures were partitioned with a common vortex mixer to generate picoliter-scale polydisperse droplets in several seconds. The limit of detection (LoD) for the target DNA and RNA is approximately 100 aM and 10 aM, respectively, which is about 3 × 10⁴-10⁵ fold more sensitive than corresponding bulk CRISPR assays. We applied the PddCas to successfully detect severe acute respiratory syndrome coronavirus (SARS-CoV-2) and human papillomavirus type 18 (HPV 18) in clinical samples. For the 23 HPV 18-suspected cervical epithelial cell samples and 32 nasopharyngeal swabs for SARS-CoV-2, 100% sensitivity and 100% specificity were demonstrated. The dual-gene virus detection with PddCas was also established and verified. Therefore, PddCas has potential for point-of-care application and is envisioned to be readily deployed for frequent testing as part of an integrated public health surveillance program.

Ring-Pins combined with cable cerclage for the fixation of displaced inferior patellar pole fractures

Objective

The study aimed to present the clinical results and complication rates of ring-pins with cable cerclage for treating the inferior pole of patella fracture.

Method

A study that retrospectively reviewed consecutive patients of the displaced inferior pole of patella fracture (AO/OTA 34-A1) operated with a ring-pin tension band using cable cerclage between October 2015 and October 2017 was performed. The duration of surgery, motion range of the knee, function outcomes, and complications were recorded.

Results

The average follow-up of 31 patients was 21 months. The mean operation time was 50 min. Fractures in all 31 patients healed at a mean duration of 8 weeks. There was no infection, no withdrawing of ring-pins, no implant breakage, and no loss of fracture reduction. The mean range of motion was 120°, and no patient complained of implant irritation at the final follow-up. The average Bostman score was 29.0 points, and 28 patients graded clinical outcomes excellent and 3 patients graded clinical outcomes good at the last follow-up.

Conclusions

Ring-pin combined with cable cerclage for treating the displaced inferior pole of patellar fracture is simple, and the postoperative internal fixation-related complication rate is low. It is a good choice for treating the displaced inferior pole of the patellar fracture.

Longitudinal Association and Mediating Mechanism Between Externalizing and Internalizing Problems Among Children: A Within-Person Analysis

OBJECTIVE

In this multi-informant, 3-year longitudinal study, the bidirectional relations between externalizing and internalizing problems were investigated, along with whether peer victimization and academic achievement mediated their relations after separating between-person effects from within-person effects.

METHOD

A sample of 3238 Chinese children (55.02% boys; Mage T1 = 9.89 years) reported semiannually on peer victimization and both externalizing and internalizing problems, and parents reported on their children's externalizing and internalizing problems. Students' objective academic achievement data (i.e. final exam scores) were obtained from school records.

RESULTS

Random intercepts cross-lagged panel modeling (RI-CLPM) revealed that neither academic achievement nor peer victimization mediated the relations between externalizing and internalizing problems in both self and parent reports at the within-person level. The cross-lagged panel models (CLPM) results supported that peer victimization (but not academic achievement) mediated the relations from internalizing to externalizing problems or externalizing to internalizing problems, whether self-reported or parent-reported. This study also identified meaningful sex differences in focal relations among children.

CONCLUSIONS

Findings illustrate the importance of distinguishing within-person and between- person associations, with within- person findings failing to support the hypothesized mediating pathways of the Dual Failure or Acting Out Models among children.

Superiorly Stable Three-Layer Air Microbubbles Generated by Versatile Ethanol-Water Exchange for Contrast-Enhanced Ultrasound Theranostics

Microbubbles have been widely used as ultrasound contrast agents in clinical diagnosis. Moreover, most current preparation methods for microbubbles are uncontrollable, and the as-obtained microbubbles are unstable in aqueous solution or under ultrasound. Here, we report a strategy to prepare superiorly stable microbubbles with three-layer structures by the ethanol-water exchange. This versatile method can also be applied to prepare different kinds of protein microbubbles with various sizes for advanced biomedical applications. To demonstrate this, the protein air microbubbles are created, which is stable in water for several days with intact structures and exhibits excellent contrast-enhanced ultrasound imaging. Moreover, the protein air microbubbles can also deliver a mass of drugs while maintaining their stable structures, making them a platform for ultrasound imaging-guided drug delivery. The versatile protein air microbubbles have great potential for the design and application of theranostic platforms.

Steroid-resistant nephrotic syndrome associated with certain SGPL1 variants in a family: Case report and literature review

OBJECTIVES

Steroid-resistant nephrotic syndrome (SRNS) is a clinical syndrome characterized by the lack of response to standard steroid therapy, usually progressing to end-stage renal disease. We reported two cases of female identical twins with SRNS caused by SGPL1 variants in one family, reviewed the relevant literature, and summarized their clinical phenotypes, pathological types, and genotypic characteristics.

METHODS

Two cases of nephrotic syndrome caused by SGPL1 variants were admitted to Tongji Hospital, affiliated with Tongji Medical College of Huazhong University of Science and Technology. Their clinical data were retrospectively collected, and the peripheral blood genomic DNA was captured and sequenced by whole exome sequencing. Related literature published in PubMed, CNKI, and Wan fang databases was reviewed.

RESULTS

We described two Chinese identical twin girls with isolated SRNS due to compound heterozygous variants in the SGPL1 (intron4 c.261 + 1G > A and intron12 c.1298 + 6T > C). The patients were followed up for 60.0 months and 53.0 months, respectively, having no extra-renal manifestations. They all died due to renal failure. A total of 31 children with SGPL1 variants causing nephrotic syndrome (including the reported two cases) were identified through a literature review.

CONCLUSIONS

These two female identical twins were the first reported cases of isolated SRNS caused by SGPL1 variants. Almost all homozygous and compound heterozygous variants of SGPL1 had extra-renal manifestations, but compound heterozygous variants in the intron of SGPL1 may have no obvious extra-renal manifestations. Additionally, a negative genetic testing result does not completely rule out genetic SRNS because the Human Gene Mutation Database or ClinVar is constantly being updated.

Cyber-victimization and Suicidal Ideation in Adolescents: A Longitudinal Moderated Mediation Model

Cyber-victimization is a significant risk factor for suicidal ideation among adolescents. However, little research has studied how cyber-victimization may impact suicidal ideation over time, and little is known about what protective factors can buffer against these associations. Guided by the integrated motivational-volitional model of suicidal behavior, this longitudinal study inspected the mediating role of hopelessness in the relation between cyber-victimization and suicidal ideation and the moderating roles of mindfulness and perceived social support in those mediating associations. A total of 1110 Chinese early adolescents (46.1% female; M_age at Wave 1 = 12.90 years) participated in a three-wave longitudinal study with 6-month intervals. The results showed that cyber-victimization positively predicted adolescents' suicidal ideation 1 year later, and this effect was fully mediated by hopelessness. Mindfulness buffered against the predictive effect of cyber-victimization on hopelessness, and perceived social support buffered against the predictive effect of hopelessness on suicidal ideation. The results further showed that the indirect effect of hopelessness was more salient when there were lower levels of mindfulness and perceived social support. This study reveals the moderated mediation processes explaining the impact of cyber-victimization on adolescents' suicidal ideation. Fostering youth's mindfulness and providing social support may attenuate the effects by which cyber-victimization causes suicidal ideation via hopelessness.

Facile Synthesis of Vertically Arranged CNTs for Efficient Solar-Driven Interfacial Water Evaporation

Solar-driven evaporation of water is a sustainable and promising technology for addressing the crisis of clean water. Herein, novel vertically arranged carbon nanotube (V-CNT) aerogels with a tree branch structure is facilely synthesized through an ice templating method. The V-CNT-based photothermal evaporator exhibits efficient broadband light trapping and super-hydrophilicity. Owing to the unique structure and ultrafast water transportation, a high evaporation rate of 3.26 kg m-2 h-1 was achieved by the three-dimensional V-CNT-based evaporator under a solar illumination of 1 kW m-2. More significantly, the V-CNT shows excellent recycling stability and salt-resistant performance in seawater and may provide a novel strategy to the practical sustainable technique of water purification applications.

Minichromosome maintenance gene family: potential therapeutic targets and prognostic biomarkers for lung squamous cell carcinoma

The minichromosome maintenance (MCM) gene family comprises of ten members with key roles in eukaryotic DNA replication and are associated with the occurrence and progression of many tumors. However, whether the MCM family contributes to lung squamous cell carcinoma (LUSC) is unclear. In this study, we performed bioinformatic analysis to identify the roles of MCM genes in patients with LUSC. We also evaluated their differential gene expression, prognostic correlation, DNA methylation, functional enrichment of genetic alterations, and immunomodulation. According to the Tumor Immune Estimation Resource database, the expression of MCM2-10 mRNA was elevated in LUSC tissues. According to the Gene Expression Profiling Interactive Analysis database, MCM2-8 and MCM10 were considerably upregulated in LUSC tissues, and protein levels of all MCMs were increased in LUSC tissues. In addition, among the MCM family members, the expression of MCM3 and MCM7 showed the strongest correlation with the prognoses of patients with LUSC. To clarify the role and mechanisms of the MCM family, Kyoto Encyclopedia of Genes and Genomes and Gene Ontology enrichment studies were performed. We detected a significant correlation between the expression patterns of MCM family members and infiltrating immune cells. In conclusion, our results improve the understanding of the aberrant expression of MCM family members in LUSC. These findings demonstrate the potential of the MCM family as therapeutic targets and biomarkers for the diagnosis and prognosis of LUSC.

In Situ Forming Epidermal Bioelectronics for Daily Monitoring and Comprehensive Exercise

Conventional epidermal bioelectronics usually do not conform well with natural skin surfaces and are susceptible to motion artifact interference, due to incompatible dimensions, insufficient adhesion, imperfect compliance, and usually require complex manufacturing and high costs. We propose in situ forming hydrogel electrodes or electronics (ISF-HEs) that can establish highly conformal interfaces on curved biological surfaces without auxiliary adhesions. The ISF-HEs also have favorable flexibility and soft compliance comparable to human skin (≈0.02 kPa^-1), which can stably maintain synchronous movements with deformed skins. Thus, the as-prepared ISF-HEs can accurately monitor large and tiny human motions with short response time (≈180 ms), good biocompatibility, and excellent performance. The as-obtained nongapped hydrogel electrode-skin interfaces achieve ultralow interfacial impedance (≈50 KΩ), nearly an order of magnitude lower than commercial Ag|AgCl electrodes as well as other reported dry and wet electrodes, regardless of the intrinsic micro-obstacles (wrinkles, hair) and skin deformation interference. Therefore, the ISF-HEs can collect high-quality electrocardiography and surface electromyography (sEMG) signals, with high signal-to-noise ratio (SNR ≈ 32.04 dB), reduced signal crosstalk, and minimized motion artifact interference. Simultaneously monitoring human motions and sEMG signals have also been implemented for the general exercise status assessment, such as the shooting competition in the Olympics. The as-prepared ISF-HEs can be considered as supplements/substitutes of conventional electrodes in percutaneously noninvasive monitoring of multifunctional physiological signals for health and exercise status.

[Association of body mass index and waist circumference with frailty among people aged 80 years and older in Chinese]

Objective: To examine the association of body mass index (BMI) and waist circumference (WC) with frailty among oldest-old adults in China. Methods: A total of 7 987 people aged 80 years and older (oldest-old) who participated in the Chinese Longitudinal Healthy Longevity Survey (CLHLS) in 2017-2018 were included. Information on demographic characteristics, behavior pattern, diet, activities of daily living, cognitive function, health status, disease condition were collected by questionnaire and physical examination. Generalized linear mixed model and restricted cubic splines (RCS) were used to analyze the association of BMI and WC with frailty. Results: The mean age of all participants was 91.7 years, and their mean BMI and WC were (21.3±3.5) kg/m² and (82.9±10.5) cm, respectively. The proportion of male was 42.3% (3 377/7 987), and the proportion of people with frailty was 33.7% (2 664/7 987). After controlling confounding factors, compared with T₂ (19.1-22.1 kg/m²) of BMI, the OR (95%CI) of the female T₁ (<19.1 kg/m²) and T₃ (≥22.2 kg/m²) group was 1.39 (1.17-1.65) and 1.27 (1.07-1.52), respectively. Compared with T₂ (77-85 cm) of WC, the OR (95%CI) of female T₁ (<77 cm) and T₃ (≥86 cm) group was 1.20 (1.01-1.42) and 1.10 (0.93-1.31), respectively. The results of multiple linear regression model with restrictive cubic spline showed that there was a non-linear association of BMI and WC with frailty in female. Conclusion: There is a U-shaped association of BMI and WC with frailty in female participants.