A Woman with Klippel-Trenaunay Syndrome Reproductive Tract Bleeding Case Report and Review of the Literature

Klippel-Trenaunay syndrome (KTS) is a rare congenital vascular disorder characterized by wine stains, abnormal tissue and bone growth, and vascular malformations. Genital involvement is uncommon. We report a case of a 12-year-old female with KTS who experienced recurrent profuse vaginal bleeding and provide a comprehensive literature review on KTS cases with genital involvement. The literature reports 7 cases, mainly in individuals aged 25 to 45, presenting with uncontrollable vaginal bleeding and anemia. Endovascular interventions were the primary treatment, although surgery was necessary in some cases. Recent studies have identified a potential association between KTS and the PIK3CA gene mutation, offering insights for pharmacological treatment.

Evaluation of the Xpert Xpress GBS test for rapid detection of group B Streptococcus in pregnant women

IMPORTANCE

This was the first study evaluating the performance of the Xpert Xpress group B Streptococcus (GBS) test using rectovaginal swabs from Chinese pregnant women. Compared to the other three assays, the Xpert Xpress GBS test demonstrated high sensitivity and specificity when screening 939 pregnant women for GBS in rectovaginal specimens. Additionally, its reduced time to obtain results makes it valuable for the rapid detection of GBS.

Clinical features and prognosis of COVID-19 patients with metabolic syndrome: A multicenter, retrospective study

Background

Few studies have investigated the impacts of metabolic syndrome (MS) on coronavirus disease 2019 (COVID-19). We described the clinical features and prognosis of confirmed COVID-19 patients with MS during hospitalization and after discharge.

Methods

Two hundred and thirty-three COVID-19 patients from the hospitals in 8 cities of Jiangsu, China were retrospectively included. Clinical characteristics of COVID-19 patients were described and risk factors of severe illness were analyzed by logistic regression analysis.

Results

Forty-five (19.3%) of 233 COVID-19 patients had MS. The median age of COVID-19 patients with MS was significantly higher than non-MS patients (53.0 years vs. 46.0 years, P = 0.004). There were no significant differences of clinical symptoms, abnormal chest CT images, and treatment drugs between two groups. More patients with MS had severe illness (33.3% vs. 6.4%, P < 0.001) and critical illness (4.4% vs. 0.5%, P = 0.037) than non-MS patients. The proportions of respiratory failure and acute respiratory distress syndrome in MS patients were also higher than non-MS patients during hospitalization. Multivariate analysis showed that concurrent MS (odds ratio [OR] 7.668, 95% confidence interval [CI] 3.062–19.201, P < 0.001) and lymphopenia (OR 3.315, 95% CI 1.306–8.411, P = 0.012) were independent risk factors of severe illness of COVID-19. At a median follow-up of 28 days after discharge, bilateral pneumonia was found in 95.2% of MS patients, while only 54.7% of non-MS patients presented bilateral pneumonia.

Conclusions

19.3% of COVID-19 patients had MS in our study. COVID-19 patients with MS are more likely to develop severe complications and have worse prognosis. More attention should be paid to COVID-19 patients with MS.

Clinical features and prognosis of COVID-19 patients with metabolic syndrome: A multicenter, retrospective study

BACKGROUND

Few studies have investigated the impacts of metabolic syndrome (MS) on coronavirus disease 2019 (COVID-19). We described the clinical features and prognosis of confirmed COVID-19 patients with MS during hospitalization and after discharge.

METHODS

Two hundred and thirty-three COVID-19 patients from the hospitals in 8 cities of Jiangsu, China were retrospectively included. Clinical characteristics of COVID-19 patients were described and risk factors of severe illness were analyzed by logistic regression analysis.

RESULTS

Forty-five (19.3%) of 233 COVID-19 patients had MS. The median age of COVID-19 patients with MS was significantly higher than non-MS patients (53.0 years vs. 46.0 years, P=0.004). There were no significant differences of clinical symptoms, abnormal chest CT images, and treatment drugs between two groups. More patients with MS had severe illness (33.3% vs. 6.4%, P<0.001) and critical illness (4.4% vs. 0.5%, P=0.037) than non-MS patients. The proportions of respiratory failure and acute respiratory distress syndrome in MS patients were also higher than non-MS patients during hospitalization. Multivariate analysis showed that concurrent MS (odds ratio [OR] 7.668, 95% confidence interval [CI] 3.062-19.201, P<0.001) and lymphopenia (OR 3.315, 95% CI 1.306-8.411, P=0.012) were independent risk factors of severe illness of COVID-19. At a median follow-up of 28 days after discharge, bilateral pneumonia was found in 95.2% of MS patients, while only 54.7% of non-MS patients presented bilateral pneumonia.

CONCLUSIONS

19.3% of COVID-19 patients had MS in our study. COVID-19 patients with MS are more likely to develop severe complications and have worse prognosis. More attention should be paid to COVID-19 patients with MS.

Clinical and virological course of patients with coronavirus disease 2019 in Jiangsu province, China: a retrospective, multi-center cohort study

Background

The clinical and virological course of patients with coronavirus disease 2019 (COVID-19) are lacking. We aimed to describe the clinical and virological characteristics of COVID-19 patients from 10 designated hospitals in 10 cities of Jiangsu province, China. The factors associated with the clearance of SARS-CoV-2 were investigated.

Methods

A total of 328 hospitalized patients with COVID-19 were retrospectively recruited. The epidemiological, clinical, laboratory, radiology and treatment data were collected. The associated factors of SARS-CoV-2 clearance were analyzed.

Results

The median duration of hospitalization was 16.0 days (interquartile range [IQR] 13.0–21.0 days). On multivariate Cox regression analysis, age > 60 years (hazard ratio [HR] 0.643, 95% confidence interval [CI] 0.454–0.911, P = 0.013) was associated with the delayed SARS-CoV-2 clearance, while the atomized inhalation of interferon α-2b could improve the clearance of SARS-CoV-2 (HR, 1.357, 95% CI 1.050–1.755, P = 0.020). Twenty-six (7.9%) patients developed respiratory failure and 4 (1.2%) patients developed ARDS. Twenty (6.1%) patients were admitted to the ICU, while no patient was deceased.

Conclusions

Our study found that age > 60 years was associated with the delayed SARS-CoV-2 clearance, while treated with atomized inhalation of interferon α-2b could promote the clearance of SARS-CoV-2.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12985-021-01615-y.

Risk factors of liver injury in patients with coronavirus disease 2019 in Jiangsu, China: A retrospective, multi-center study

We aimed to describe liver injury and identify the risk factors of liver injury in coronavirus disease (COVID-19) patients without chronic liver diseases (CLD). The clinical data of 228 confirmed COVID-19 patients without CLD were retrospectively collected from ten hospitals in Jiangsu, China. Sixty-seven (29.4%) of 228 patients without CLD showed abnormal liver function on admission, including increased alanine aminotransferase (ALT) (25 [11.0%]) U/L, aspartate aminotransferase (AST) 30 [13.2%]) U/L, gamma-glutamyl transferase (GGT) 28 [12.4%]) U/L, total bilirubin (Tbil) 16 [7.0%] μmol/L, and alkaline phosphatase (ALP) 10 [4.5%]) U/L. During hospitalization, 129 (56.3%) of 228 patients showed abnormal liver function, including elevated ALT (84 [36.8%]), AST (58 [25.4%]), GGT (67 [29.5%]), and Tbil (59 [25.9%]). Age over 50 years (odds ratio [OR], 2.086; 95% confidence interval [CI], 1.030-4.225; p = .041), male sex (OR, 2.737; 95% CI, 1.418-5.284; p = .003), and lopinavir-ritonavir (OR, 2.504; 95% CI, 1.187-5.283; p = .016) were associated with higher risk of liver function abnormality, while the atomized inhalation of interferon α-2b (OR, 0.256; 95% CI 0.126-0.520; p < .001) was associated with reduced risk of liver function abnormality during hospitalization. Mild to moderate liver injury was common in COVID-19 patients in Jiangsu, China. Age over 50 years, male sex, and lopinavir-ritonavir were the independent risk factors of liver impairment in COVID-19 patients during hospitalization.

Nutritional status is closely related to the severity of COVID-19: a multi-center retrospective study

INTRODUCTION

Nutritional status has been defined as an individual's health condition. The relationship between the progression of COVID-19 and Nutritional status is still unclear. We analyzed the clinical characteristics of 342 coronavirus disease 2019 (COVID-19) patients, and analyzed the relationship between the progression of COVID-19 and Nutritional status.

METHODOLOGY

342 COVID-19 were enrolled from ten different hospitals in China. The clinical characteristics were collected and analyzed.

RESULTS

The body mass index (BMI) of the mild patients (Group A) was higher than those in severe patients (Group B) and critical patients (Group C); The lactate dehydrogenase (LDH) level of Group A was lower than those of the other two groups; Sex, age, and BMI, was strongly correlated with Clinical classification (CT); Among the laboratory test results, Neutrophil (NEU%), Aspartate aminotransferase (AST), LDH, and blood glucose (BG) were positively correlated with CT; Lymphocyte ( LYM%), Platelet (PLT), Albumin (ALB), and Creatinine (Cr) were negatively correlated with CT. BMI, NEU%, LYM%, ALB, Cr, and PLT are all protective factors that affect CT.

CONCLUSION

People with poor nutritional status (lower BMI and ALB) have a higher risk of developing severe disease after infection with SARS-CoV-2. In the clinical treatment of COVID-19, individualized nutritional support is very important for the rehabilitation of patients.

Corticosteroid therapy is associated with the delay of SARS-CoV-2 clearance in COVID-19 patients

The impact of corticosteroid treatment on virological course of coronavirus disease 2019 (COVID-19) patients remains unclear. This study aimed to explore the association between corticosteroid and viral clearance in COVID-19. The clinical data of COVID-19 patients from 10 hospitals of Jiangsu, China, were retrospectively collected. Cox regression and Kaplan-Meier analysis were used to analyze the adverse factors of virus clearance. Of the 309 COVID-19 patients, eighty-nine (28.8%) patients received corticosteroid treatment during hospitalization. Corticosteroid group showed higher C-reactive protein (median 11.1 vs. 7.0 mg/l, P = 0.018) and lower lymphocytes (median 0.9 vs. 1.4 × 109/l, P < 0.001) on admission. Fever (93.3% vs. 65.0%, P < 0.001) and cough (69.7% vs. 57.3%, P = 0.043) were more common in corticosteroid group. The proportions of patients with severe illness (34.8% vs. 1.8%, P < 0.001), respiratory failure (25.8% vs. 1.4%, P < 0.001), acute respiratory distress syndrome (4.5% vs. 0%, P = 0.002), and admission to ICU (20.2% vs. 0.9%, P < 0.001) were significantly higher in corticosteroid group than non-corticosteroid group. The duration of virus clearance (median 18.0 vs. 16.0 days, P < 0.001) and hospitalization (median 17.0 vs. 15.0 days, P < 0.001) were also significantly longer in corticosteroid group than non-corticosteroid group. Treated with corticosteroid (Hazard ratio [HR], 0.698; 95% confidence interval [CI], 0.512 to 0.951; P = 0.023) was an adverse factor of the clearance of SARS-CoV-2, especially for male patients (HR, 0.620; 95% CI, 0.408 to 0.942; P = 0.025). The cumulative probability of SARS-CoV-2 clearance was lower in corticosteroid group (P < 0.001). Corticosteroid treatment may delay the SARS-CoV-2 clearance of COVID-19 patients and should be used with cautions.

Overweight and Obesity are Risk Factors of Severe Illness in Patients with COVID-19

OBJECTIVE

This study aimed to observe the clinical characteristics of patients with coronavirus disease 2019 (COVID-19) with overweight and obesity.

METHODS

Consecutive patients with COVID-19 from 10 hospitals of Jiangsu province, China, were enrolled.

RESULTS

A total of 297 patients with COVID-19 were included, and 39.39% and 13.47% of patients had overweight and obesity, respectively. The proportions of bilateral pneumonia (92.50% vs. 73.57%, P = 0.033) and type 2 diabetes (17.50% vs. 3.57%, P = 0.006) were higher in patients with obesity than lean patients. The proportions of severe illness in patients with overweight (12.82% vs. 2.86%, P = 0.006) and obesity (25.00% vs. 2.86%, P < 0.001) were significantly higher than lean patients. More patients with obesity developed respiratory failure (20.00% vs. 2.86%, P < 0.001) and acute respiratory distress syndrome (5.00% vs. 0%, P = 0.024) than lean patients. The median days of hospitalization were longer in patients with obesity than lean patients (17.00 days vs. 14.00 days, P = 0.029). Overweight (OR, 4.222; 95% CI: 1.322-13.476; P = 0.015) and obesity (OR, 9.216; 95% CI: 2.581-32.903; P = 0.001) were independent risk factors of severe illness. Obesity (HR, 6.607; 95% CI: 1.955-22.329; P = 0.002) was an independent risk factor of respiratory failure.

CONCLUSIONS

Overweight and obesity were independent risk factors of severe illness in COVID-19 patients. More attention should be paid to these patients.

Clinical features of COVID-19 patients with non-alcoholic fatty liver disease

Background and Aims

Previous studies reported that coronavirus disease 2019 (COVID-19) was likely to result in liver injury. However, few studies investigated liver injury in COVID-19 patients with chronic liver diseases. We described the clinical features in COVID-19 patients with non-alcoholic fatty liver disease (NAFLD).

Methods

Confirmed COVID-19 patients from hospitals in 10 cities of Jiangsu province, China were retrospectively included between January 18, 2020, and February 26, 2020. Hepatic Steatosis Index (HSI) was used to defined NAFLD.

Results

A total of 280 COVID-19 patients were enrolled. Eighty-six (30.7%) of 280 COVID-19 patients were diagnosed as NAFLD by HSI. 100 (35.7%) patients presented abnormal liver function on admission. The median ALT levels (34.5 U/L vs. 23.0 U/L, P<0.001) and the proportion of elevated ALT (>40 U/L) (40.7% vs. 10.8%, P<0.001) were significantly higher in patients with NAFLD than in patients without NAFLD on admission. The proportion of elevated ALT in patients with NAFLD was also significantly higher than patients without NAFLD (65.1% vs. 38.7%, P<0.001) during hospitalization. Multivariate analysis showed that age over 50 years (odds ratio [OR] 2.077, 95% confidence interval [CI] 1.183-3.648, P=0.011), and concurrent NAFLD (OR 2.956, 95% CI 1.526-5.726, P=0.001) were independent risk factors of ALT elevation in COVID-19 patients, while the atomized inhalation of interferon α-2b (OR 0.402, 95%CI 0.236-0.683, P=0.001) was associated with the reduced risk of ALT elevation during hospitalization. No patient developed liver failure or death during hospitalization. The complications and clinical outcomes were comparable between COVID-19 patients with and without NAFLD.

Conclusions

NAFLD patients are more likely to develop liver injury when infected by COVID-19. However, no patient developed severe liver-related complications during hospitalization.

Coupled Sublattice Melting and Charge-Order Transition in Two Dimensions

Two-dimensional melting is one of the most fascinating and poorly understood phase transitions in nature. Theoretical investigations often point to a two-step melting scenario involving unbinding of topological defects at two distinct temperatures. Here, we report on a novel melting transition of a charge-ordered K-Sn alloy monolayer on a silicon substrate. Melting starts with short-range positional fluctuations in the K sublattice while maintaining long-range order, followed by longer-range K diffusion over small domains, and ultimately resulting in a molten sublattice. Concomitantly, the charge order of the Sn host lattice collapses in a multistep process with both displacive and order-disorder transition characteristics. Our combined experimental and theoretical analysis provides a rare insight into the atomistic processes of a multistep melting transition of a two-dimensional materials system.

[Analysis of screening strategy of group B streptococcus in the third trimester and its influence on pregnancy outcome]

Objective: To investigate the screening strategy of group B streptococcus (GBS) in the reproductive tract of women in the third trimester and analyze its impact on pregnancy outcome. Methods: A total of 85 461 pregnant women in 35-37 weeks of gestation from Bao'an Maternity and Child Health Hospital, Jinan University from January 2011 to June 2018 were enrolled. They were divided into 3 periods according to different GBS screening strategies, the unscreened period included 31 384 cases (36.72%), 33 267 cases (38.93%) were included in partial screening period, 20 810 cases (24.35%) were included in screening period. All GBS screening positive pregnant women were given intrapartum antibiotic prophylaxis (IAP). The impact on pregnancy outcomes, and the impact of different GBS collection transport and culture methods on the positive rate of GBS screening were analyzed. Results: (1) The incidence of neonatal early onset GBS disease (EOGBSD) in unscreened period was 0.03% (11/31 773), in partial screening period was 0.02%(6/33 887), and in screening period, the incidence of neonatal EOGBSD decreased to 0, the difference was statistically significant (χ(2)=7.86, P=0.02).(2) The incidence of hematogenous infection of GBS in pregnant women was 0.02%(6/33 887) in partial screening period, and there was none in screening period, there was no significant difference (adjusted χ(2)=3.75, P=0.05). (3) In the screening period, the positive rate of GBS was 14.08%(2 719/19 306), which was significantly higher than the positive rate of GBS in the partial screening period (11.48%, 2 058/17 920; χ(2)=56.12, P=0.00). (4) Antibiotic sensitivity tests of 4 777 GBS strains showed that the antibiotics with higher resistance rate were tetracycline (81.52%, 3 896/4 777), erythromycin (66.59%, 3 181/4 777), and clindamycin (64.31%, 3 072/4 777). The combination of erythromycin, clindamycin and tetracycline was the most common resistant pattern, accounting for 48.80% (2 331/4 777). No penicillin, ceftriaxone or vancomycin resistant strains was found. Conclusions: GBS screening strategy in different regions could combine the local neonatal EOGBSD incidence rate, maternal GBS colonization rate, and the socioeconomic factors to determine whether universal GBS screening or screening for high-risk maternal women. GBS screening positive rate is related to the population, scope of the investigation, the sample collection, delivery and culture methods. The multi-drug resistance rate of GBS is high.

MicroRNA-212 inhibits proliferation of gastric cancer by directly repressing retinoblastoma binding protein 2

Retinoblastoma binding protein 2 (RBP2), a newly found histone demethylase, is overexpressed in gastric cancer. We examined the upstream regulatory mechanism of RBP2 at the microRNA (miRNA) level and the role in gastric carcinogenesis. We used bioinformatics to predict that microRNA-212 (miR-212) might be a direct upstream regulator of RBP2 and verified the regulation in gastric epithelial-derived cell lines. Overexpression of miR-212 significantly inhibited the expression levels of RBP2, whereas knockdown of miR-212 promoted RBP2 expression. Furthermore, we identified the putative miR-212 targeting sequence in the RBP2 3' UTR by luciferase assay. MiR-212 inhibited the colony formation ability of cells by repressing RBP2 expression and increasing that of P21(CIP1) and P27(kip1), both critical in cell cycle arrest. In addition, the expression of RBP2 and miR-212 in tumor tissue and matched normal tissue from 18 patients further supported the results in vivo. MiR-212 directly regulates the expression of RBP2 and inhibits cell growth in gastric cancer, which may provide new clues to treatment.

[Study of adiponectin expression in placenta and its correlation with preeclampsia]

OBJECTIVE

To investigate the expression of adiponectin in placenta and its correlation with preeclampsia.

METHODS

Placental tissues were collected from normal term pregnancies (normal pregnancy group, n = 20), mild preeclampsia (mild preeclampsia group, n = 12) and severe preeclampsia (severe preeclampsia group, n = 22). The expression of adiponectin protein and the intensity of its mRNA in placenta were detected using immunohistochemistry and RT-PCR, respectively. Integral optical density (IOD) which represents the expression level of adiponectin protein, and the ratio of adiponectin cDNA PCR products to beta-actin cDNA PCR products which represents the intensity of transcription of adiponectin mRNA in placenta were analyzed.

RESULTS

(1) The expression of adiponectin protein was observed in cytoplasm of placental cytotrophoblasts and syncytiotrophoblasts among three groups. There was no significant difference in adiponectin protein expression between maternal side and fetal side of placenta in three groups (all P > 0.05); (2) The expression of adiponectin protein in placenta in severe preeclampsia group (30 984 +/- 14 604) was significantly lower than that of mild preeclampsia group (58 360 +/- 8910, P < 0.01) and of normal pregnancy group (53 246 +/- 17 554, P < 0.01). There was also no significant difference in the expression of adiponectin protein in placenta between term delivery and preterm delivery in severe preeclampsia group (38 890 +/- 20 386 vs 29 319 +/- 8997, P > 0.05), however, the expression of adiponectin protein in placenta in term delivery of severe preeclampsia group was significantly lower than that of term delivery of normal pregnancy group (38 890 +/- 20 386 vs 53 246 +/- 17 554, P < 0.05); (3) The expression of adiponectin mRNA was detected in placental tissues among three groups also. The intensity of transcription of adiponectin in placenta in severe preeclampsia group (1.0 +/- 0.2) was markedly lower than that of mild preeclampsia group (2.9 +/- 0. 8, P < 0.05) and normal pregnancy group (3.3 +/- 1.1, P = 0.000).

CONCLUSION

The expression of adiponectin decreases in placenta tissues of severe preeclampsia, indicating that the abnormal expression of adiponectin may be involved in the pathogenesis of preeclampsia.

[Study on spectrophotometric determination of trace nitrite with brilliant cresol blue]

A new spectrophotometric method for the determination of trace nitrite was studied. The method is based on the diazo-reaction of brilliant cresol blue with nitrite. The linear range for the determination is 0.5-12 microg NO2(-)/25 mL. The detection limit is 0.5 microg NO2(-)/25 mL. The method has been used for the determination of trace nitrite in water. The mechanism of the reaction was discussed.

Progressive detachment of cells from surfaces: a consequence of heterogeneous ligand populations or a multi-site binding equilibrium?

A multi-site binding equilibrium model is proposed to describe the effect of applied shear on the detachment of affinity adsorbed particles or cells from surfaces. Unlike earlier models used to describe this phenomenon the current approach considers the extent to which multiple interactions show surface cooperativity such that the attached fraction can be described in terms of a number of subpopulations linked via differing numbers of ligand/receptor interactions.

Operational properties of an inverted matrix cellulose CM ion-exchanger

Productive CM is a recently available carboxymethyl ion-exchanger based on cellulose supplied by BPS Separation. It is supplied in an 'inverted matrix' form as a coherent structure with large voids and about 90% free volume. This paper reports mainly on the physical properties and robustness under normal use conditions using lysozyme as a model protein. The structure is shown by electron microscopy to be formed of fibrous or sheet material around macropores of around 100 microns in diameter. The material around the macropores is itself porous down to the smallest pores visible at perhaps 50 nm. The capacity under static and dynamic conditions was measured and found in both cases to be only slightly dependent on applied flow velocities up to 8 m h-1. The high porosity allowed cider fermentation broth and diluted egg white to be applied directly to a column without blockage and at a moderate pressure drop yet with a high superficial velocity. Compression of the bed at high flow rates did not occur at free space velocities up to 17 m h-1 with water and slightly lower with other fluids. The adsorption isotherm was determined and found to follow a Langmuir form. It proved to be totally stable to immersion in 1 M NaOH and 1 M NaCl without any measurable volume changes. Many of the properties were compared with those of other ion-exchange resins and found to be equivalent in capacity but superior in terms of stability, sustainable flow rates and dynamic capacity. It is concluded that the stability, performance under high flow rates and good capacity make it eminently suitable for use in large scale applications.

Resolution and productivity of conalbumin and lysozyme from fresh egg-white loaded at very high flow rate on a 250-mm length CM-HVFM column

A 250 x 10 mm I.D. column of CM-HVFM, a novel carboxymethyl ion-exchange matrix, has been used as a preparative chromatographic column to separate fresh egg-white protein. When loading a diluted egg-white solution at pH 4.8 ovalbumin was not adsorbed and lysozyme was preferentially adsorbed compared to the conalbumin. As the column loading was increased from 24 to 450 kg m-3 column volume at the superficial velocity of 6.12 m h-1, the lysozyme continued to be absorbed eventually displacing conalbumin. A maximum lysozyme productivity at 16.7 kg m-3 h-1 was achieved at the highest loading. For conalbumin a maximum productivity of 8.8 kg m-3 h-1 occurred at the lower loading of 100 kg m-3. The purities of lysozyme and conalbumin were comparable at a column loading of 450 kg m-3 h-1. The performance of the column was not degraded, neither was the column blocked or channelled despite the high column loading at the high flow-rate.