Nitrogen-Vacancy-Rich VN Clusters Embedded in Carbon Matrix for High-Performance Zinc Ion Batteries

Vanadium nitride (VN) is a potential cathode material with high capacity and high energy density for aqueous zinc batteries (AZIBs). However, the slow kinetics resulting from the strong electrostatic interaction of the electrode materials with zinc ions is a major challenge for fast storage. Here, VN clusters with nitrogen-vacancy embedded in carbon (C) (Nv -VN/C-SS-2) are prepared for the first time to improve the slow reaction kinetics. The nitrogen vacancies can effectively accelerate the reaction kinetics, reduce the electrochemical polarization, and improve the performance. The density functional theory (DFT) calculations also prove that the rapid adsorption and desorption of zinc ions on Nv -VN/C-SS-2 can release more electrons to the delocalized electron cloud of the material, thus adding more active sites. The Nv -VN/C-SS-2 exhibits a specific capacity and outstanding cycle life. Meanwhile, the quasi-solid-state battery exhibits a high capacity of 186.5 mAh g-1 , ultra-high energy density of 278.9 Wh kg-1 , and a high power density of 2375.1 W kg-1 at 2.5 A g-1 , showing excellent electrochemical performance. This work provides a meaningful reference value for improving the comprehensive electrochemical performance of VN through interface engineering.

Silver oxide decorated urchin-like microporous organic polymer composites as versatile antibacterial organic coating materials

Microporous organic polymers (MOPs) and metal oxide hybrid composites are considered valuable coating materials because of their versatility derived from the synergistic combination of MOPs' inherent dispersibility and the distinctive properties of metal oxides. In this study, we present the synthesis of sea-urchin-like MOPs hybridised with silver oxide nanoparticles (Ag2O NPs) to fabricate antibacterial composites suitable for potential antibacterial coating applications. Ag2O NP-decorated urchin-like MOPs (Ag2O@UMOPs) were synthesised by employing a combination of two methods: a one-pot Lewis acid-base interaction-mediated self-assembly and a straightforward impregnation process. The as-prepared Ag2O@UMOPs demonstrated high antibacterial efficacy against both E. coli (G-) and S. aureus (G+). The antibacterial mechanism of Ag2O@UMOPs mainly involved the synergistic effects of accumulation of Ag2O@UMOPs, the release of Ag+ ions, and the generation of reactive oxygen species. The exceptional processability and biosafety of Ag2O@UMOPs make them ideal organic coating materials for convenient application on various substrates. These remarkable features of Ag2O@UMOPs provide an effective platform for potential antibacterial applications in biological sciences.

Dynamic increase in myoglobin level is associated with poor prognosis in critically ill patients: a retrospective cohort study

Background

Myoglobin is an important biomarker for monitoring critically ill patients. However, the relationship between its dynamic changes and prognosis remains unclear.

Methods

We retrospectively enrolled 11,218 critically ill patients from a general and surgical intensive care unit (ICU) of a tertiary hospital between June 2016 and May 2020. Patients with acute cardiovascular events, cardiac and major vascular surgeries, and rhabdomyolysis were excluded. To investigate the early myoglobin distribution, the critically ill patients were stratified according to the highest myoglobin level within 48 h after ICU admission. Based on this, the critically ill patients with more than three measurements within 1 week after ICU admission were included, and latent class trajectory modeling was used to classify the patients. The characteristics and outcomes were compared among groups. Sensitivity analysis was performed to exclude patients who had died within 72 h after ICU admission. Restricted mean survival time regression model based on pseudo values was used to determine the 28-day relative changes in survival time among latent classes. The primary outcome was evaluated with comparison of in-hospital mortality among each Trajectory group, and the secondary outcome was 28-day mortality.

Results

Of 6,872 critically ill patients, 3,886 (56.5%) had an elevated myoglobin level (≥150 ng/mL) at admission to ICU, and the in-hospital mortality significantly increased when myoglobin level exceeded 1,000 μg/mL. In LCTM, 2,448 patients were unsupervisedly divided into four groups, including the steady group (n = 1,606, 65.6%), the gradually decreasing group (n = 523, 21.4%), the slowly rising group (n = 272, 11.1%), and the rapidly rising group (n = 47, 1.9%). The rapidly rising group had the largest proportion of sepsis (59.6%), the highest median Sequential Organ Failure Assessment (SOFA) score (10), and the highest in-hospital mortality (74.5%). Sensitivity analysis confirmed that 98.2% of the patients were classified into the same group as in the original model. Compared with the steady group, the rapidly rising group and the slowly rising group were significantly related to the reduction in 28-day survival time (β = -12.08; 95% CI -15.30 to -8.86; β = -4.25, 95% CI -5.54 to -2.97, respectively).

Conclusion

Elevated myoglobin level is common in critically ill patients admitted to the ICU. Dynamic monitoring of myoglobin levels offers benefit for the prognosis assessment of critically ill patients.

Poly(Glutamic Acid)-Engineered Nanoplatforms for Enhanced Cancer Phototherapy

Phototherapies, including photothermal therapy and photodynamic therapy, have gained booming development over the past several decades for their attractive non-invasiveness nature, negligible adverse effects, minimal systemic toxicity, and high spatial selectivity. Phototherapy usually requires three components: light irradiation, photosensitizers, and molecular oxygen. Photosensitizers can convert light energy into heat or reactive oxygen species, which can be used in the tumor-killing process. The direct application of photosensitizers in tumor therapy is restricted by their poor water solubility, fast clearance, severe toxicity, and low cellular uptake. The encapsulation of photosensitizers into nanostructures is an attractive strategy to overcome these critical limitations. Poly(glutamic acid) (PGA) is a kind of poly(amino acid)s containing the repeating units of glutamic acid. PGA has superiority for cancer treatment because of its good biocompatibility, low immunogenicity, and modulated pH responsiveness. The hydrophilicity nature of PGA allows the physical entrapment of photosensitizers and anticancer drugs via the construction of amphiphilic polymers. Moreover, the pendent carboxyl groups of PGA enable chemical conjugation with therapeutic agents. In this mini-review, we highlight the stateof- the-art design and fabrication of PGA-based nanoplatforms for phototherapy. We also discuss the potential challenges and future perspectives of phototherapy, and clinical translation of PGA-based nanomedicines.

Early peripheral blood lymphocyte subsets and cytokines in predicting the severity of influenza B virus pneumonia in children

Background

Children with influenza B virus infection have a higher susceptibility and higher severity of illness. The activation and disorder of immune function play an important role in the severity of influenza virus infection. This study aims to investigate whether early lymphocyte count and cytokines can provide predictive value for the progression in children with influenza B virus pneumonia.

Methods

A retrospective cohort study was conducted to analyze the clinical data of children with influenza B virus pneumonia from December 1, 2021, to March 31, 2022, in the National Children's Regional Medical Center (Shengjing Hospital of China Medical University). According to the severity of the disease, the children were divided into a mild group and a severe group, and the clinical characteristics, routine laboratory examination, lymphocyte subsets, and cytokines were compared.

Results

A total of 93 children with influenza B virus pneumonia were enrolled, including 70 cases in the mild group and 23 cases in the severe group. Univariate analysis showed that drowsiness, dyspnea, white blood cell (WBC), lymphocytes, monocytes, procalcitonin, alanine aminotransferase (ALT), aspartate aminotransferase (AST), creatine kinase-MB (CK-MB), lactate dehydrogenase (LDH), fibrinogen (FIB), Immunoglobulin M (IgM), lung consolidation, total T cell count, CD4⁺ T cell count, CD8⁺ T cell count, NK cell count, NK cell % and B cell % had statistical differences between the mild and severe groups (P<0.05). In multivariate logistic regression analysis, reduced ALT (OR = 1.016), FIB (OR = 0.233), CD8⁺ T cell count (OR = 0.993) and NK cell count (OR = 0.987) were independently associated with the development of severe influenza B virus pneumonia.

Conclusions

The levels of T lymphocytes and NK cells were related to the progression of influenza B virus pneumonia in children, and the reduction of CD8⁺ T cell count and NK cell count can be used as independent risk factors for predicting the severity of influenza B virus pneumonia.

Bean Sprouts-like Cobalt Selenium Phosphorus-nanosheets Composed Anode Toward Fast and High Sodium-ion Storage

Metal-organic framework (MOF) is used to thermally grow cobalt selenophosphide (CoSeP) nanoparticles on N-doped 2-dimensional carbon matrix (CoSeP@N-C), resulting in an assembled unique 3-dimensional bean sprouts-like nanosheets composite with massive...

Bacterial meningitis in children with an abnormal craniocerebral structure

Background

We studied the causative pathogens, clinical characteristics, and outcome of bacterial meningitis in children with an abnormal craniocerebral structure.

Methods

A retrospective single-center study was conducted on children aged in the range of 29 days to 14 years by using data obtained from the pediatric intensive care unit in Shengjing Hospital between January 2014 and August 2021. All children were diagnosed with bacterial meningitis. They were divided into complex and simple groups by taking into account the presence of an abnormal craniocerebral structure before they contracted bacterial meningitis. We collected data on demographics, clinical presentations, laboratory results, imaging studies, treatments, and outcomes.

Results

A total of 207 patients were included in the study (46 in the complex group and 161 in the simple group). Patients in the complex group had a lower mortality rate (6.5% vs. 11.2%, p < 0.05), positive blood culture (13.0% vs. 34.8%; p < 0.05), multiple organ dysfunction syndrome (0% vs. 9.3%; p < 0.05), and shock (2.2% vs. 9.3%; p = 0.11). These patients were more often detected with neurological sequelae (80.4% vs. 53.4%; p < 0.05), cerebrospinal fluid drainage (50% vs. 15.5%; p < 0.05), nosocomial infection (54.3% vs. 3.1%; p < 0.05), and multidrug-resistant bacteria (62.5% vs. 55.6%, p = 0.501). In patients in the simple group, infection was mostly confined to the nervous system.

Conclusion

Bacterial meningitis patients with an abnormal craniocerebral structure had fewer bloodstream infections, lower mortality rates, and higher incidence rates of neurological sequelae. Pathogens were more likely to be nosocomial and multidrug-resistant bacteria.

ATIC-Associated De Novo Purine Synthesis Is Critically Involved in Proliferative Arterial Disease

BACKGROUND

Proliferation of vascular smooth muscle cells (VSMCs) is a hallmark of arterial diseases, especially in arterial restenosis after angioplasty or stent placement. VSMCs reprogram their metabolism to meet the increased requirements of lipids, proteins, and nucleotides for their proliferation. De novo purine synthesis is one of critical pathways for nucleotide synthesis. However, its role in proliferation of VSMCs in these arterial diseases has not been defined.

METHODS

De novo purine synthesis in proliferative VSMCs was evaluated by liquid chromatography-tandem mass spectrometry. The expression of ATIC (5-aminoimidazole-4-carboxamide ribonucleotide formyltransferase/inosine monophosphate cyclohydrolase), the critical bifunctional enzyme in the last 2 steps of the de novo purine synthesis pathway, was assessed in VSMCs of proliferative arterial neointima. Global and VSMC-specific knockout of Atic mice were generated and used for examining the role of ATIC-associated purine metabolism in the formation of arterial neointima and atherosclerotic lesions.

RESULTS

In this study, we found that de novo purine synthesis was increased in proliferative VSMCs. Upregulated purine synthesis genes, including ATIC, were observed in the neointima of the injured vessels and atherosclerotic lesions both in mice and humans. Global or specific knockout of Atic in VSMCs inhibited cell proliferation, attenuating the arterial neointima in models of mouse atherosclerosis and arterial restenosis.

CONCLUSIONS

These results reveal that de novo purine synthesis plays an important role in VSMC proliferation in arterial disease. These findings suggest that targeting ATIC is a promising therapeutic approach to combat arterial diseases.

Electrospun Zein/Polyoxyethylene Core-Sheath Ultrathin Fibers and Their Antibacterial Food Packaging Applications

The purpose of this work is to develop a novel ultrathin fibrous membrane with a core-sheath structure as antibacterial food packaging film. Coaxial electrospinning was exploited to create the core-sheath structure, by which the delivery regulation of the active substance was achieved. Resveratrol (RE) and silver nanoparticles (AgNPs) were loaded into electrospun zein/polyethylene oxide ultrathin fibers to ensure a synergistic antibacterial performance. Under the assessments of a scanning electron microscope and transmission electron microscope, the ultrathin fiber was demonstrated to have a fine linear morphology, smooth surface and obvious core-sheath structure. X-ray diffraction and Fourier transform infrared analyses showed that RE and AgNPs coexisted in the ultrathin fibers and had good compatibility with the polymeric matrices. The water contact angle experiments were conducted to evaluate the hydrophilicity and hygroscopicity of the fibers. In vitro dissolution tests revealed that RE was released in a sustained manner. In the antibacterial experiments against Staphylococcus aureus and Escherichia coli, the diameters of the inhibition zone of the fiber were 8.89 ± 0.09 mm and 7.26 ± 0.10 mm, respectively. Finally, cherry tomatoes were selected as the packaging object and packed with fiber films. In a practical application, the fiber films effectively reduced the bacteria and decreased the quality loss of cherry tomatoes, thereby prolonging the fresh-keeping period of cherry tomatoes to 12 days. Following the protocols reported here, many new food packaging films can be similarly developed in the future.

Intelligent poly(l-histidine)-based nanovehicles for controlled drug delivery

Stimuli-responsive drug delivery systems based on polymeric nanovehicles are among the most promising treatment regimens for malignant cancers. Such intelligent systems that release payloads in response to the physiological characteristics of tumor sites have several advantages over conventional drug carriers, offering, in particular, enhanced therapeutic effects and decreased toxicity. The tumor microenvironment (TME) is acidic, suggesting the potential of pH-responsive nanovehicles for enhancing treatment specificity and efficacy. The synthetic polypeptide poly(l-histidine) (PLH) is an appropriate candidate for the preparation of pH-responsive nanovehicles because the pK_a of PLH (approximately 6.0) is close to the pH of the acidic TME. In addition, the pendent imidazole rings of PLH yield pH-dependent hydrophobic-to-hydrophilic phase transitions in the acidic TME, triggering the destabilization of nanovehicles and the subsequent release of encapsulated chemotherapeutic agents. Herein, we highlight the state-of-the-art design and construction of pH-responsive nanovehicles based on PLH and discuss the future challenges and perspectives of this fascinating biomaterial for targeted cancer treatment and "benchtop-to-clinic" translation.

Lymphocyte trajectories are associated with prognosis in critically ill patients: A convenient way to monitor immune status

Background

Immunosuppression is a risk factor for poor prognosis of critically ill patients, but current monitoring of the immune status in clinical practice is still inadequate. Absolute lymphocyte count (ALC) is not only a convenient biomarker for immune status monitoring but is also suitable for clinical application. In this study, we aimed to explore different trajectories of ALC, and evaluate their relationship with prognosis in critically ill patients.

Methods

We retrospectively enrolled 10,619 critically ill patients admitted to a general intensive care unit (ICU) with 56 beds from February 2016 to May 2020. Dynamic ALC was defined as continuous ALC from before ICU admission to 5 days after ICU admission. Initial ALC was defined as the minimum ALC within 48 h after ICU admission. Group-based trajectory modeling (GBTM) was used to group critically ill patients according to dynamic ALC. Multivariate cox regression model was used to determine the independent association of trajectory endotypes with death and persistent inflammation, immunosuppression, catabolism syndrome (PICS).

Results

A total of 2022 critically ill patients were unsupervisedly divided into four endotypes based on dynamic ALC, including persistent lymphopenia endotype (n = 1,211; 58.5%), slowly rising endotype (n = 443; 22.6%), rapidly decreasing endotype (n = 281; 14.5%) and normal fluctuation endotype (n = 87; 4.4%). Among the four trajectory endotypes, the persistent lymphopenia endotype had the highest incidence of PICS (24.9%), hospital mortality (14.5%) and 28-day mortality (10.8%). In multivariate cox regression model, persistent lymphopenia was associated with increased risk of 28-day mortality (HR: 1.54; 95% CI: 1.06–2.23), hospital mortality (HR: 1.66; 95% CI: 1.20–2.29) and PICS (HR: 1.79; 95% CI: 1.09–2.94), respectively. Sensitivity analysis further confirmed that the ALC trajectory model of non-infected patients and non-elderly patients can accurately distinguished 91 and 90% of critically ill patients into the same endotypes as the original model, respectively.

Conclusion

The ALC trajectory model is helpful for grouping critically ill patients, and early persistent lymphopenia is associated with poor prognosis. Notably, persistent lymphopenia may be a robust signal of immunosuppression in critically ill patients.

Porous organic polymers for drug delivery: hierarchical pore structures, variable morphologies, and biological properties

Porous organic polymers have received considerable attention in recent years because of their applicability as biomaterials. In particular, their hierarchical pore structures, variable morphologies, and tunable biological properties make them suitable as drug-delivery systems. In this review, the synthetic and post forming/control methods including templated methods, template-free methods, mechanical methods, electrospun methods, and 3D printing methods for controlling the hierarchical structures and morphologies of porous organic polymers are discussed, and the different methods affecting their specific surface areas, hierarchical structures, and unique morphologies are highlighted in detail. In addition, we discuss their applications in drug encapsulation and the development of stimuli (pH, heat, light, and dual-stimuli)-responsive materials, focusing on their use for targeted drug release and as therapeutic agents. Finally, we present an outlook concerning the research directions and applications of porous polymer-based drug delivery systems.

Electrospun Core (HPMC-Acetaminophen)-Shell (PVP-Sucralose) Nanohybrids for Rapid Drug Delivery

The gels of cellulose and its derivatives have a broad and deep application in pharmaceutics; however, limited attention has been paid to the influences of other additives on the gelation processes and their functional performances. In this study, a new type of electrospun core-shell nanohybrid was fabricated using modified, coaxial electrospinning which contained composites of hydroxypropyl methyl cellulose (HPMC) and acetaminophen (AAP) in the core sections and composites of PVP and sucralose in the shell sections. A series of characterizations demonstrated that the core-shell hybrids had linear morphology with clear core-shell nanostructures, and AAP and sucralose distributed in the core and shell section in an amorphous state separately due to favorable secondary interactions such as hydrogen bonding. Compared with the electrospun HPMC-AAP nanocomposites from single-fluid electrospinning of the core fluid, the core-shell nanohybrids were able to promote the water absorbance and HMPC gelation formation processes, which, in turn, ensured a faster release of AAP for potential orodispersible drug delivery applications. The mechanisms of the drug released from these nanofibers were demonstrated to be a combination of erosion and diffusion mechanisms. The presented protocols pave a way to adjust the properties of electrospun, cellulose-based, fibrous gels for better functional applications.

[Study on determination of 2-thioxothiazolidine-4-carboxylic Acid in urine by high performance liquid chromatography]

Objective: To establish a high performance liquid chromatography method for the determination of 2-thioxothiazolidine-4-carboxylic acid (TTCA) in urine. Methods: After acidification with hydrochloric acid, TTCA in urine was first extracted by ethyl acetate with excessive sodium chloride, then gradient separated by a symmetry C18 column and then detected by a diode array detector. The quantification was based on a working curve of external standard method. Results: The linear relationship of TTCA in urine was good in the range of 0.03-10.00 mg/L, and the correlation coefficient was 0.9999. The detection limit and minimum quantitative concentration of TTCA in urine were 0.008 mg/L and 0.027 mg/L. The intra-assay precision of the method was 0.9%-1.4%, the inter-assay precision was 1.3%-3.5%, and the average recovery was 85.0%-92.7% while the concentrations of TTCA in urine was 0.8, 2.0 and 8.0 mg/L, respectively (n=6) . Conclusion: The gradient elution high performance liquid chromatography method has simple operation and high sensitivity, and it is suitable for the determination of TTCA on a low level in urine for occupational workers exposure to carbon disulfide.

Polymer-Based Nanofiber-Nanoparticle Hybrids and Their Medical Applications

The search for higher-quality nanomaterials for medicinal applications continues. There are similarities between electrospun fibers and natural tissues. This property has enabled electrospun fibers to make significant progress in medical applications. However, electrospun fibers are limited to tissue scaffolding applications. When nanoparticles and nanofibers are combined, the composite material can perform more functions, such as photothermal, magnetic response, biosensing, antibacterial, drug delivery and biosensing. To prepare nanofiber and nanoparticle hybrids (NNHs), there are two primary ways. The electrospinning technology was used to produce NNHs in a single step. An alternate way is to use a self-assembly technique to create nanoparticles in fibers. This paper describes the creation of NNHs from routinely used biocompatible polymer composites. Single-step procedures and self-assembly methodologies are used to discuss the preparation of NNHs. It combines recent research discoveries to focus on the application of NNHs in drug release, antibacterial, and tissue engineering in the last two years.

[Attention should be paid to the establishment and management of glaucoma records]

Glaucoma is the world's leading cause of irreversible blindness. As a chronic disease, it requires lifelong follow-up and management. In the long-term follow-up of glaucoma patients, a diagnosis and treatment management system is helpful. Despite the availability of various means of informationalized record management, there remain problems and challenges, like a lack of unified file management standards, data incompatibility, and barriers to inter-hospital data sharing, which lead to the failure to establish a comprehensive and standardized glaucoma record for patients. It is necessary to form a standardized management system so as to improve the efficiency and accuracy of the diagnosis and treatment of glaucoma, better maintain the visual function of patients and reduce the burden on society and family.

New Therapies for Lowering Triglyceride-Rich Lipoproteins: JACC Focus Seminar 3/4

Emerging evidence suggests that elevated concentrations of triglyceride-rich lipoprotein remnants (TRLs) derived from hepatic and intestinal sources contribute to the risk of atherosclerotic cardiovascular events. Natural selection studies support a causal role for elevated concentrations of remnant cholesterol and the pathways contributing to perturbations in metabolic pathways regulating TRLs with an increased risk of atherosclerotic cardiovascular disease events. New therapies targeting select catalytic pathways in TRL metabolism reduce atherosclerosis in experimental models, and concentrations of TRLs in patients with a vast range of triglyceride levels. Clinical trials with inhibitors of angiopoietin-like 3 protein and apolipoprotein C-III will be required to provide further guidance on the potential contribution of these emerging therapies in the paradigm of cardiovascular risk management in patients with elevated remnant cholesterol.

The effect of whole-body vibration training with different amplitudes on bone mineral density in elderly women

BACKGROUND: The effects of whole-body vibration training (WBVT) with same frequency and different amplitudes on bone mineral density (BMD) in the elderly is not reported. OBJECTIVE: To compare the effect of 45-Hz WBVT with different amplitudes on the BMD in elderly women. METHODS: Age-, height-, and weight-matched patients were assigned to a low-amplitude group (n= 19, amplitude of 2 mm), medium-amplitude group (n= 18, amplitude of 3 mm), high-amplitude group (n= 19, amplitude 4 mm), and control group (n= 20). The WBVT was conducted for 24 weeks in the three amplitude groups. The BMD at lumbar vertebrae L2-4 and the proximal femur was measured at 0 and 24 weeks. RESULTS: The BMD at lumbar vertebrae L2-4 was higher in the high-amplitude group than in the low-amplitude and middle-amplitude groups, and the BMD of the greater trochanter was significantly higher than that in the low-amplitude group (p< 0.05). The BMD of the greater trochanter was significantly higher in the middle- than low-amplitude group (p< 0.05). CONCLUSION: A higher amplitude should be considered when WBVT is performed in elderly patients to increase bone density and prevent osteoporosis.

[Determination of five phenolic compounds in workplace air by composite sampling tube-high performance liquid chromatography]

Objective: To develop a method for simultaneous determination of Dydroquinone, Resorcinol, Pyrocatechol, 4-Nitrophenol and 2, 4-Dinitrophenol in workplace air by high performance liquid chromatography. Methods: Air samples were collected by composite tube (front end glass fiber filter membrane, back section silica gel) , 10% methanol was desorbed, separated by C18 chromatographic column, detected by photo-diode array (PDA) detector, and quantitatively determined by external standard method at the wave-length of 230 nm. Results: The linear relationship of 5 phenolic compounds was good (r>0.999) . The detection limit of glass fiber filtration membrane and silica gel adsorbent were 0.13-0.41 g/ml and 0.16-1.04 g/ml respectively. The quantitative limit of glass fiber filtration membrane was 0.44-1.36 g/ml, and the silica gel adsorbent was 0.52-3.46 g/ml. The average desorption efficiency of glass fiber membrane and silica gel adsorbent were 97.5%-100.1% and 86.9%-100.3%, respectively. In and between batches, the precision glass fiber filtration membrane was 0.71%-4.88%, 0.91%-4.82%, silica gel adsorbent was 0.47%-4.62%, 0.76%-5.52%. Samples can be stored for at least 30 days at -20 ℃. The possible co-existing interferences of aniline, phenol, p-nitrochlorobenzene, o-nitrophenol and trinitrophenyl did not interfere with the determination. Conclusion: The sensitivity, precision, accuracy and linear range of this method all meet the requirements of the specification. The collection and preservation of samples can also meet the requirements of the limits. It is suitable for the simultaneous determination of hydroquinone, resorcinol, hydroquinone, hydroquinone, hydroquinone, p-nitrophenol and 2, 4-dinitrophenol in the air of the workplace.

The Clinical Characteristics of Fever-Ward Pediatric Patients with a Definite Epidemiological History During the Early COVID-19 Epidemic Period

OBJECTIVE

The number of children presenting with coronavirus disease 2019 (COVID-19) caused by SARS-CoV-2 infection is increasing, and we aimed to assess the clinical characteristics of pediatric patients with a definite epidemiological history during the early COVID-19 epidemic.

METHODS

Retrospective analysis was performed on the clinical data of children admitted to the fever ward of Xiangyang Central Hospital in Hubei province between January 1, 2020 and March 17, 2020. According to definite epidemiological history, patients with SARS-CoV-2 nucleic acid test (NAT) positive detection were grouped as confirmed cases, and patients with two consecutive negative NATs were grouped as suspected cases. We compared the clinical characteristics of the two groups.

RESULTS

A total of 47 (47/127, 37%) cases had a definite epidemiological history, of which 32 (68.1%) were suspected, with a median age of 5.5 years (interquartile range [IQR]: 0.7-10.3), and 15 (31.9%) were confirmed, with a median age of 9 years (IQR: 4-14). Statistically significant differences in age, family cluster of infection, and numbers of patients with clinical symptoms and fever (P<0.05) were found between the two groups, but no statistically significant differences in leucocyte and lymphocyte counts were observed (P>0.05). Significant differences were found in the computed tomography (CT) manifestation of ground glass opacity (GGO) between the two groups (P<0.05).

CONCLUSION

Children of older age and from family clusters of infection were more easily diagnosed as having COVID-19. GGO changes on chest CT was more likely in confirmed cases. Although obvious clinical manifestations increase our awareness of COVID-19, children without manifestations of fever or cough should not be ignored as they may be asymptomatic carriers.

Inhibition of micro RNA miR-122-5p prevents lipopolysaccharide-induced myocardial injury by inhibiting oxidative stress, inflammation and apoptosis via targeting GIT1

Myocardial injury resulting from sepsis is the leading cause of death worldwide. Micro RNA miR-122-5p is involved in various physiological and pathological processes and is highly expressed in the heart of septic rats. However, its function in sepsis-caused myocardial injury remains elusive. Herein, a rat model of septic myocardial injury was established by intraperitoneal injection of lipopolysaccharide (LPS), and cardiomyocyte H9c2 was exposed to LPS to induce sepsis-related inflammatory injury in vitro. Inhibition of miR-122-5p suppressed LPS-triggered myocardial injury evidenced by decreased heart weight index (HWI), reduced inflammatory cell infiltration and cell rupture, and reduced cardiac marker enzymes cTnI and LDH. MiR-122-5p inhibition inhibited ROS production and enhanced the activities of antioxidant enzymes CAT, SOD and GSH-px in LPS-treated rats and H9c2 cells. MiR-122-5p inhibition reduced the production of pro-inflammatory cytokines TNF-α, IL-6 and IL-1β, and inhibited cell apoptosis along with decreased cleaved-caspase 3 induced by LPS. Moreover, increased GIT1 expression was found following miR-122-5p inhibition. We further verified GIT1 as a target of miR-122-5p, and silencing GIT1 partially reversed the benefits of miR-122-5p loss in LPS-injured H9c2 cells. The HO-1 and NQO-1 expression and Nrf-2 activation were enhanced by miR-122-5p inhibition, which was reversed by GIT1 depletion, indicating the involvement of Nrf-2/HO-1 signaling in regulating miR-122-5p/GIT1-mediated cardioprotection. Taken together, our data suggest that inhibition of miR-122-5p may mitigate sepsis-triggered myocardial injury through inhibiting inflammation, oxidative stress and apoptosis via targeting GIT1, which provides a possible therapeutic target for sepsis.

[The controversy and value of the combination of hydrocortisone, ascorbic acid and thiamine in treating sepsis]

Sepsis is a common cause of death in intensive care unit. Some retrospective studies had shown the combination of hydrocortisone, ascorbic acid and thiamine (HAT therapy) could lower mortality rate of patients with sepsis or septic shock. Recently, multiple randomized controlled trials(RCTs) related to the efficacy of combination therapy don't reach a consensus. Though one meta-analysis indicated beneficial effect of HAT regimen on decreasing mortality rate of patients with sepsis or septic shock, improving SOFA score and reducing use of vasopressor. However, controversy still exist in the target population, timing, dose and duration of HAT regimen. Thus, the optimized RCTs are needed to provide more definitive evidence.

Effect of Kinesio taping on delayed-onset muscle soreness in elite athletes

BACKGROUND

This research analyzes the effect of Kinesio taping on delayed-onset muscle soreness in elite athletes because delayed-onset muscle soreness increases the risk of injury in sports.

METHODS

Elite female volleyball players (n=31) were randomly divided into experimental (n=16, with Kinesio taping of the knee) and control (n=15) groups. To elicit delayed-onset soreness in knee joint muscles, the protocol that we used consisting of downhill running, visual analog pain score assessment, and measurements of serum interleukin-6 and creatine kinase concentrations immediately and after 24 hours, 48 hours, and 72 hours.

RESULTS

Compared with the control group, the pain reported by the athletes with Kinesio taping decreased 24 hours and 48 hours (P<0.05) after running, but there was no significant difference 72 hours (P<0.05) after running. Interleukin-6 concentrations were lower in the athletes with Kinesio taping than those in the control group immediately and 24 hours (P<0.05) after running, but there was no significant difference 48 hours and 72 hours (P<0.05) after running. There were no significant differences (P>0.05) in creatine kinase concentrations.

CONCLUSIONS

The use of Kinesio taping in elite athletes is an effective protective strategy for alleviating pain symptoms caused by delayed-onset muscle soreness, but it is not effective to alleviate the skeletal muscle microinjury caused by delayed-onset muscle soreness.

Urinary Trypsin Inhibitor Protects Tight Junctions of Septic Pulmonary Capillary Endothelial Cells by Regulating the Functions of Macrophages

BACKGROUND

Our previous study found that urinary trypsin inhibitor (ulinastatin, UTI) protected tight junctions (TJs) of lung endothelia via TNF-α inhibition, thereby alleviating pulmonary capillary permeability in septic rats. As the activated macrophage is the main source of TNF-α in sepsis, we speculate that UTI may exert the above effects by regulating the functions of macrophages.

METHODS

Bone-marrow derived macrophages (BMDM) were divided into control, lipopolysaccharide (LPS), UTI+LPS and UTI groups. TNF-α, TGF-β, IL-10, CD86, CD206 and MCP-1 expression were assessed by Western blot. The phagocytosis and migration of BMDM were detected. Pulmonary microvascular endothelial cells (PMVECs) were cultured with the conditioned medium (CM) from each group of BMDM above. Sprague-Dawley rats were divided into sham, cecal ligation and puncture (CLP), and UTI+CLP groups. Western blot and immunofluorescence were used to detected zonula occludens-1 (ZO-1), occludin and claudin-5 expression in PMVECs, as well as TNF-α, TGF-β, iNOS, CD86 and CD206 expression in lungs. Pulmonary capillary permeability was assessed by extravasated Evans blue, lung injury score (LIS), wet-to-dry weight ratio and electron microscope.

RESULTS

TNF-α and CD86 expression were increased in LPS-treated BMDM, but were reversed by UTI pretreatment. TGF-β, IL-10 and CD206 expression were the opposite. UTI markedly decreased phagocytosis and migration of LPS-treated BMDM. ZO-1, occludin and claudin-5 expression were markedly decreased in PMVECs of the CM-LPS group, but significantly increased in the CM-UTI+LPS group. TNF-α, iNOS and CD86 expression were increased in the lungs of CLP-rats but decreased with UTI pretreatment, while TGF-β and CD206 expression were the opposite. UTI markedly ameliorated the lung EB leakage, improved LIS, reduced the wet-to-dry ratio and revised the damaged TJs of PMVECs in CLP-rats.

CONCLUSION

UTI effectively inhibits the conversion of M1 macrophage but increases M2, reduces the phagocytosis and migration, which helps to protect endothelia TJs and reduce pulmonary capillary permeability during sepsis.

Efficient Synthesis of Folate-Conjugated Hollow Polymeric Capsules for Accurate Drug Delivery to Cancer Cells

This study presents an efficient and systematic approach to synthesize bioapplicable porous hollow polymeric capsules (HPCs). The hydroxyl-functionalized nanoporous polymers with hollow capsular shapes could be generated via the moderate Friedel-Crafts reaction without using any hard or soft template. The numerous primitive hydroxyl groups on these HPCs were further converted to carboxyl groups. Owing to the abundance of highly branched carboxyl groups on the surface of the HPCs, biomolecules [such as folic acid (FA)] could be covalently decorated on these organic capsules (FA-HPCs) for drug delivery applications. The intrinsic hollow porosities and specific targeting agent offered a maximum drug encapsulation efficiency of up to 86% and drug release of up to 50% in 30 h in an acidic environment. The in vitro studies against cancer cells demonstrated that FA-HPCs exhibited a more efficient cellular uptake and intracellular doxorubicin release than bare HPCs. This efficient approach to fabricate carbonyl-functionalized hollow organic capsules may open avenues for a new type of morphological-controlled nanoporous polymers for various potential bioengineering applications.

Nano Aggregate Formation Through Self-Assembly of Poly(L-lysine)-Block-Poly(γ-benzyl-L-glutamate)-Graft-Poly(ethylene glycol) Copolymer

Polymeric nano aggregates based on poly(L-lysine)-block-PBLG-graft-poly(ethylene glycol) (PLL-b-PBLG-g-PEG) copolymers were prepared by a dialysis method in deionized water. PLL-b-PBLG-g-PEG copolymers with different degrees of PEG substitution were synthesized by combining the ring-opening polymerization of α-amino acid N-carboxyanhydrides and ester exchange reactions. Proton nuclear magnetic resonance spectroscopy and gel permeation chromatography were employed to confirm the polymer structures and molecular weights. Transmission electron microscopy and dynamic light scattering were used to observe the self-assembly behavior. The experimental results revealed that the volume content of deionized water in the mixture significantly affects the morphology and size of the aggregates formed by PLL-b-PBLG-g-PEG copolymers. Spherical, spindle-like, needle-like, and daisy-like aggregates were observed with an increase in the volume content of deionized water in the mixture.

Clinical features of pediatric patients with coronavirus disease (COVID-19)

BACKGROUND

Coronavirus disease 2019 (COVID-19) caused by SARS-CoV-2 has spread around the world, and reports of children with COVID-19 are increasing.

OBJECTIVES

To assess clinical profiles of pediatric COVID-19.

STUDY DESIGN

A retrospective analysis was undertaken using clinical data of sixteen children (11 months-14 years) diagnosed with COVID-19 between January 1, 2020 and March 17, 2020 at Xiangyang Central Hospital, Hubei province, China.

RESULTS

All children had positive epidemiologic histories, 12 (12/16, 75 %) involving family units. The illnesses were either mild (5/16, 31.3 %) or ordinary (11/16, 68.8 %), presenting as follows: asymptomatic (8/16, 50 %), fever and/or cough (8/16, 50 %). Four asymptomatic patients (4/16, 25 %) in ordinary cases had chest computed tomography (CT) abnormalities. Leukocyte counts were normal in 14 cases(88 %), but 2 patients (12.5 %) had leukopenia, and 1 (6.3 %) was lymphopenic. There were 11 patients with chest CT abnormalities, some nodular, others small patchy and others ground-glass opacities. In asymptomatic children, the median time to SRAS-CoV-2 nucleic acid test(NAT) positivity once exposed to a family member with confirmed infection was 15.5 days (range, 10-26 days). The median time to first NAT-negative conversion was 5.5 days (range, 1-23 days).

CONCLUSIONS

COVID-19 in children of Xiangyang city is often family acquired and not serious, with favorable outcomes. Asymptomatic children can be diagnosed as pneumonia because of chest CT abnormalities. It is essential to actively screen this segment of the population.

Pharmacological Therapeutics Targeting RNA-Dependent RNA Polymerase, Proteinase and Spike Protein: From Mechanistic Studies to Clinical Trials for COVID-19

An outbreak of novel coronavirus-related pneumonia COVID-19, that was identified in December 2019, has expanded rapidly, with cases now confirmed in more than 211 countries or areas. This constant transmission of a novel coronavirus and its ability to spread from human to human have prompted scientists to develop new approaches for treatment of COVID-19. A recent study has shown that remdesivir and chloroquine effectively inhibit the replication and infection of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2, 2019-nCov) in vitro. In the United States, one case of COVID-19 was successfully treated with compassionate use of remdesivir in January of 2020. In addition, a clinically proven protease inhibitor, camostat mesylate, has been demonstrated to inhibit Calu-3 infection with SARS-CoV-2 and prevent SARS-2-spike protein (S protein)-mediated entry into primary human lung cells. Here, we systemically discuss the pharmacological therapeutics targeting RNA-dependent RNA polymerase (RdRp), proteinase and S protein for treatment of SARS-CoV-2 infection. This review should shed light on the fundamental rationale behind inhibition of SARS-CoV-2 enzymes RdRp as new therapeutic approaches for management of patients with COVID-19. In addition, we will discuss the viability and challenges in targeting RdRp and proteinase, and application of natural product quinoline and its analog chloroquine for treatment of coronavirus infection. Finally, determining the structural-functional relationships of the S protein of SARS-CoV-2 will provide new insights into inhibition of interactions between S protein and angiotensin-converting enzyme 2 (ACE2) and enable us to develop novel therapeutic approaches for novel coronavirus SARS-CoV-2.

Patterns of Deterioration in Moderate Patients With COVID-19 From Jan 2020 to Mar 2020: A Multi-Center, Retrospective Cohort Study in China

Background: Around the globe, moderate cases account for the largest proportion of all coronavirus disease 2019 (COVID-19) patients, and deteriorated moderate patients contribute the most in mortality. However, published articles failed to address the deterioration details of moderate cases, especially on when and how they deteriorated. Methods: All moderate COVID-19 patients hospitalized in Guangdong Province from January 14 to March 16, 2020, were included in this multicenter retrospective cohort study and were divided into deteriorated and non-deteriorated groups according to clinical status. Symptoms and demographic, therapeutic, and laboratory test result characteristics were collected to explore the features of disease deterioration. Results: Of 1,168 moderate patients included, 148 (13%) deteriorated to severe (130 cases) or critical (18 cases) status. Over 20% of the older subgroup (>50 years old) showed deterioration. The median time for deterioration was 11 days after onset [interquartile range (IQR) 9-14 days]. In addition, 12.2% severe cases could further develop to critical status after 3 days (IQR 2-6.5 days) of having a severe condition. Respiratory dysfunction and hypoxia were the major manifestations as disease deterioration, while 76 cases (52.1%) showed respiratory rate >30 breaths/min, 119 cases (80.4%) showed SaO₂ <93%, 100 cases (67.5%) had 201 < PaO₂/FiO₂ < 300, and 27 cases (18.9%) had blood lactic acid >2.0 mmol/L. In view of multiple organ dysfunction, 87.8% of acute respiratory distress syndrome (ARDS), 20.2% of acute kidney injury (AKI), 6.8% of coagulopathy, 4% of acute heart failure (AHF), 3.4% of acute hepatic injury (AHI), and 5.4% of shock occurred in deteriorated patients, while organ injury occurred in the following sequence: ARDS, AKI, AHF, coagulopathy, AHI, and shock. Conclusions: The deteriorated pattern of moderate COVID-19 patients is characterized as the 11th day from onset (IQR 9-14 days) being an important time point of disease deterioration with further exacerbation to critical condition in 3 days (IQR 2-6.5 days), A RDS followed by AKI being the typical modes of sequential organ damage.

Facile and scalable synthesis of topologically nanoengineered polypeptides with excellent antimicrobial activities

A facile and scalable strategy for the quick library synthesis of linear-, hinged-, star-, and cyclic-polypeptides with broad-spectrum antimicrobial activity has been reported.

Modified sites and functional consequences of 4-oxo-2-nonenal adducts in HDL that are elevated in familial hypercholesterolemia

The lipid aldehyde 4-oxo-2-nonenal (ONE) is a highly reactive protein crosslinker derived from peroxidation of n-6 polyunsaturated fatty acids and generated together with 4-hydroxynonenal (HNE). Lipid peroxidation product-mediated crosslinking of proteins in high-density lipoprotein (HDL) causes HDL dysfunction and contributes to atherogenesis. Although HNE is relatively well-studied, the role of ONE in atherosclerosis and in modifying HDL is unknown. Here, we found that individuals with familial hypercholesterolemia (FH) had significantly higher ONE-ketoamide (lysine) adducts in HDL (54.6 ± 33.8 pmol/mg) than healthy controls (15.3 ± 5.6 pmol/mg). ONE crosslinked apolipoprotein A-I (apoA-I) on HDL at a concentration of > 3 mol ONE per 10 mol apoA-I (0.3 eq), which was 100-fold lower than HNE, but comparable to the potent protein crosslinker isolevuglandin. ONE-modified HDL partially inhibited HDL's ability to protect against lipopolysaccharide (LPS)-induced tumor necrosis factor α (TNFα) and interleukin-1β (IL-1β) gene expression in murine macrophages. At 3 eq, ONE dramatically decreased apoA-I exchange from HDL, from ∼46.5 to ∼18.4% (p < 0.001). Surprisingly, ONE modification of HDL or apoA-I did not alter macrophage cholesterol efflux capacity. LC-MS/MS analysis revealed that Lys-12, Lys-23, Lys-96, and Lys-226 in apoA-I are modified by ONE ketoamide adducts. Compared with other dicarbonyl scavengers, pentylpyridoxamine (PPM) most efficaciously blocked ONE-induced protein crosslinking in HDL and also prevented HDL dysfunction in an in vitro model of inflammation. Our findings show that ONE-HDL adducts cause HDL dysfunction and are elevated in individuals with FH who have severe hypercholesterolemia.

Guided Assembly of Well-Defined Hierarchical Nanoporous Polymers by Lewis Acid-Base Interactions

Three-dimensional hierarchical nanoporous polymers and carbon nanomaterials with well-defined superstructures are of great interest for various intelligent applications, whereas a facile and versatile approach to access those materials with a high surface area, stable well-defined morphology, and ordered pores still remains a significant challenge. Herein, we report a self-regulated Lewis acid-base interaction-mediated assembly strategy for the in situ synthesis of morphology-engineered hyper-cross-linked porous polymers and carbon materials. A series of functionalized aromatic compounds (FAC) is subjected to self-cross-linking via classic Friedel-Crafts chemistry to achieve stable porous polymers with a high surface area. Varying the monomer/catalyst combination had a dramatic effect on the acid-base interaction, facilitating the tailoring of the self-assembled morphologies from nanotubes to hollow nanospheres, and even nanosheets. A mechanistic study showed that the byproducts generated during cross-linking orchestrate the interactions between the catalyst (acid) and FAC (base) and simultaneously drive the self-assembly to yield specific morphologies. Based on the rigid hollow polymer framework and intrinsic hydroxyl functionality, the hyper-cross-linked hollow nanospheres were easily transformed to an acid-functionalized catalyst for efficient biodiesel production. Moreover, high-quality porous carbonaceous nanocounterparts such as carbon nanotubes, hollow carbon nanospheres, and carbon nanosheets could also be produced by direct pyrolysis of the corresponding polymer precursors. These findings may provide guidance for the facile design of morphology-controlled functionalized polymers and carbon nanomaterials for various applications.

Mussel-Inspired Poly(3,4-dihydroxy-L-phenylalanine)-Block-Poly(γ-benzyl-L-glutamate) Bioconjugate-Assisted Green Synthesis of Silver Nanoparticles

Hybrid polymeric micelles self-assembled from a mixture containing poly(3,4-dihydroxy-L-Phenylalanine)-Block-poly(γ-benzyl-L-glutamate) diblock copolymer bioconjugates and silver nanoparticles were reported. A series of amphiphilic copolymers with different molecular weights were synthesized via ring-opening polymerization of α-amino acid N-carboxyanhydrides. The polymer backbone was demonstrated via proton nuclear magnetic resonance spectroscopy and Fourier-transform infrared spectroscopy. It was observed that the resulting amphiphilic copolymer can self-assemble into rod-like micelles in dimethyl formamide/ethanol mixtures as confirmed via transmission electron microscopy. In addition, the formed rod-like micelles transformed to vesicular micelles upon introducing silver nanoparticles into the amphiphilic copolymer solution. The effect of silver nanoparticles content on the vesicle formation process was also studied. Spindle-like micelles were observed sequentially before the formation of the vesicles.

Palladium Nanoparticle-Decorated Porous Carbon Nanoflakes as High-Activity Catalyst for Electrooxidation of Alcohol

A facile technique for the preparation of a multicomponent electrocatalyst that shows promising activity for the electrooxidation of alcohol has been demonstrated. The synthesis involves the preparation of hyper-crosslinked polydichloroxylene solid nanoflakes that are hybridized with PdCl₂. The hybrid is reduced in an aqueous NaBH₄ solution to fabricate Pd nanoparticle-decorated hyper-crosslinked polydichloroxylene. Finally, the polymer-supported palladium nanoparticles are subjected to thermal pyrolysis to form Pd-decorated carbon nanoflakes. The unique porous construction of these carbon nanoflakes result in high surface area and robust stability. The evaluation of the Pd-decorated carbon nanoflakes electrocatalyst shows improved performance and stability with high reaction efficiency for the electrooxidation of alcohols such as methanol.

Polypill for Cardiovascular Disease Prevention in an Underserved Population

BACKGROUND

Persons with low socioeconomic status and nonwhite persons in the United States have high rates of cardiovascular disease. The use of combination pills (also called "polypills") containing low doses of medications with proven benefits for the prevention of cardiovascular disease may be beneficial in such persons. However, few data are available regarding the use of polypill therapy in underserved communities in the United States, in which adherence to guideline-based care is generally low.

METHODS

We conducted a randomized, controlled trial involving adults without cardiovascular disease. Participants were assigned to the polypill group or the usual-care group at a federally qualified community health center in Alabama. Components of the polypill were atorvastatin (at a dose of 10 mg), amlodipine (2.5 mg), losartan (25 mg), and hydrochlorothiazide (12.5 mg). The two primary outcomes were the changes from baseline in systolic blood pressure and low-density lipoprotein (LDL) cholesterol level at 12 months.

RESULTS

The trial enrolled 303 adults, of whom 96% were black. Three quarters of the participants had an annual income below $15,000. The mean estimated 10-year cardiovascular risk was 12.7%, the baseline blood pressure was 140/83 mm Hg, and the baseline LDL cholesterol level was 113 mg per deciliter. The monthly cost of the polypill was $26. At 12 months, adherence to the polypill regimen, as assessed on the basis of pill counts, was 86%. The mean systolic blood pressure decreased by 9 mm Hg in the polypill group, as compared with 2 mm Hg in the usual-care group (difference, -7 mm Hg; 95% confidence interval [CI], -12 to -2; P = 0.003). The mean LDL cholesterol level decreased by 15 mg per deciliter in the polypill group, as compared with 4 mg per deciliter in the usual-care group (difference, -11 mg per deciliter; 95% CI, -18 to -5; P<0.001).

CONCLUSIONS

A polypill-based strategy led to greater reductions in systolic blood pressure and LDL cholesterol level than were observed with usual care in a socioeconomically vulnerable minority population. (Funded by the American Heart Association Strategically Focused Prevention Research Network and the National Institutes of Health; ClinicalTrials.gov number, NCT02278471.).

Identification and characterization of cherry (Cerasus pseudocerasus G. Don) genes responding to parthenocarpy induced by GA3 through transcriptome analysis

Background

Fruit set after successful pollination is key for the production of sweet cherries, and a low fruit-setting rate is the main problem in production of this crop. As gibberellin treatment can directly induce parthenogenesis and satisfy the hormone requirement during fruit growth and development, such treatment is an important strategy for improving the fruit-setting rate of sweet cherries. Previous studies have mainly focused on physiological aspects, such as fruit quality, fruit size, and anatomical structure, whereas the molecular mechanism remains clear.

Results

In this study, we analyzed the transcriptome of ‘Meizao’ sweet cherry fruit treated with gibberellin during the anthesis and hard-core periods to identify genes associated with parthenocarpic fruit set. A total of 25,341 genes were identified at the anthesis and hard-core stages, 765 (681 upregulated, 84 downregulated) and 186 (141 upregulated, 45 downregulated) of which were significant differentially expressed genes (DEGs) at the anthesis and the hard-core stages after gibberellin 3 (GA3) treatment, respectively. Based on DEGs between the control and GA3 treatments, the GA3 response mainly involves parthenocarpic fruit set and cell division. Exogenous gibberellin stimulated sweet cherry fruit parthenocarpy and enlargement, as verified by qRT-PCR results of related genes as well as the parthenocarpic fruit set and fruit size. Based on our research and previous studies in Arabidopsis thaliana, we identified key genes associated with parthenocarpic fruit set and cell division. Interestingly, we observed patterns among sweet cherry fruit setting-related DEGs, especially those associated with hormone balance, cytoskeleton formation and cell wall modification.

Conclusions

Overall, the result provides a possible molecular mechanism regulating parthenocarpic fruit set that will be important for basic research and industrial development of sweet cherries.

Electronic supplementary material

The online version of this article (10.1186/s12863-019-0746-8) contains supplementary material, which is available to authorized users.

[Association of low serum indirect bilirubin level with all-cause mortality in maintenance hemodialysis patients]

Objective: To investigate the association of low serum indirect bilirubin (IBIL) level with all-cause mortality in maintenance hemodialysis (MHD) patients. Methods: A multicenter retrospective cohort study was conducted in seven hemodialysis centers of Guizhou province. The adult outpatients who underwent hemodialysis for more than 3 months were included between June 2015 and June 2016. Demographics, baseline clinical and laboratory test results were collected. Patients were divided into 4 groups according to their baseline serum IBIL levels (interquartile range), and followed up until June 30, 2018. Kaplan-Meier method was used to compare the survival rate of each group. Cox regression model was used to analyze the association of IBIL with all-cause mortality. Results: A total of 885 hemodialysis dialysis patients with baseline IBIL data were enrolled in this study, with age of (55.4±16.2) years old, among whom 57.9% (512/885) were male. Median IBIL was 4.8 μmol/L and interquartile range was 3.3-7.0 μmol/L. The comparison between IBIL quartile groups showed that the differences in proportion of diabetics, hemoglobin, serum albumin, platelet, serum calcium, alanine aminotransferase (ALT), uric acid and urea nitrogen were statistically significant (all P<0.05). After a median follow-up of 24 months, 210 patients died, and 96 cases became lost to follow-up. Kaplan-Meier curves showed higher all-cause mortality in patients with IBIL≤3.3 μmol/L (Q1 group) (65/219, P=0.015). After adjusting for age, gender, comorbidities, and biochemical indicators, taking baseline IBIL Q2 level (IBIL 3.4~4.8 μmol/L) as a reference, the hazard ratio for all-cause death in patients with IBIL≤3.3 μmol/L was 1.661 (95%CI: 1.114-2.476, P=0.013). Kaplan-Meier survival curve showed that there was no significant difference in mortality between the quartile groups according to total bilirubin (TBIL) or direct bilirubin (DBIL) (P=0.167, 0.156). Conclusion: Baseline low serum IBIL in maintenance hemodialysis patients is associated with all-cause mortality.

[Effect of data missing on population based viral load survey in HIV infected men who have sex with men sampled in 16 large cities, China]

Objective: To analyze the effect of missing data in population based viral load (PVL) survey in HIV infected men who have sex with men (MSM) sampled in 16 cities in China. Methods: The database of 3 virus load sampling survey conducted consecutively in HIV infected MSM population in 16 large cities (Beijing, Shanghai, Nanjing, Hangzhou, Wuhan, Chongqing, Kunming, Xi'an, Guangzhou, Shenzhen, Nanning, Urumuqi, Harbin, Changchun, Chengdu and Tianjin) during 2013-2015 was used. SPSS 17.0 software was used to describe distribution of the missing data and analyze associated factors. Results: A total of 12 150 HIV infected MSM were randomly selected for the surveys, in whom, 9 141 (75.2%) received virus load tests, while 3 009 (24.8%) received no virus load tests, whose virus load data missed. The virus load data missing rates in MSM with or without access to antiretroviral therapy (ART) were 11.5% (765/6 675) and 39.4% (2 060/5 223) respectively, and the virus load data missing rates were 21.9% (1 866/8 523) and 28.4% (959/3 374), respectively, in local residents and non-local residents (migrants). Conclusions: The analysis indicated that the data missing occurred in the virus load survey in HIV infected MSM population. ART status and census registering status were the main influencing factors. Data missing could influence the accurate evaluation of community viral load (CVL) and population viral load(PVL) levels in HIV infected MSM in China.

[Data distribution and transformation in population based sampling survey of viral load in HIV positive men who have sex with men in China]

Objective: To understand the distribution of population viral load (PVL) data in HIV infected men who have sex with men (MSM), fit distribution function and explore the appropriate estimating parameter of PVL. Methods: The detection limit of viral load (VL) was ≤ 50 copies/ml. Box-Cox transformation and normal distribution tests were used to describe the general distribution characteristics of the original and transformed data of PVL, then the stable distribution function was fitted with test of goodness of fit. Results: The original PVL data fitted a skewed distribution with the variation coefficient of 622.24%, and had a multimodal distribution after Box-Cox transformation with optimal parameter (λ) of-0.11. The distribution of PVL data over the detection limit was skewed and heavy tailed when transformed by Box-Cox with optimal λ=0. By fitting the distribution function of the transformed data over the detection limit, it matched the stable distribution (SD) function (α=1.70, β=-1.00, γ=0.78, δ=4.03). Conclusions: The original PVL data had some censored data below the detection limit, and the data over the detection limit had abnormal distribution with large degree of variation. When proportion of the censored data was large, it was inappropriate to use half-value of detection limit to replace the censored ones. The log-transformed data over the detection limit fitted the SD. The median (M) and inter-quartile ranger (IQR) of log-transformed data can be used to describe the centralized tendency and dispersion tendency of the data over the detection limit.

[Comparison of different methods in dealing with HIV viral load data with diversified missing value mechanism on HIV positive MSM]

Objective: To compare results of different methods: in organizing HIV viral load (VL) data with missing values mechanism. Methods We used software SPSS 17.0 to simulate complete and missing data with different missing value mechanism from HIV viral loading data collected from MSM in 16 cities in China in 2013. Maximum Likelihood Methods Using the Expectation and Maximization Algorithm (EM), regressive method, mean imputation, delete method, and Markov Chain Monte Carlo (MCMC) were used to supplement missing data respectively. The results: of different methods were compared according to distribution characteristics, accuracy and precision. Results HIV VL data could not be transferred into a normal distribution. All the methods showed good results in iterating data which is Missing Completely at Random Mechanism (MCAR). For the other types of missing data, regressive and MCMC methods were used to keep the main characteristic of the original data. The means of iterating database with different methods were all close to the original one. The EM, regressive method, mean imputation, and delete method under-estimate VL while MCMC overestimates it. Conclusion: MCMC can be used as the main imputation method for HIV virus loading missing data. The iterated data can be used as a reference for mean HIV VL estimation among the investigated population.

[Effect of laboratory referencing on data analysis of community viral load in HIV positive MSM from 15 cities, China]

Objective: To compare the community viral load (CVL) among MSM in 15 cities in China using standardized national reference sources. Methods: The study analyzed the existing database of National Major Science and Technology Project of China. The database was established with serial random survey of MSM HIV CVL among MSM in 15 cities from 2013 to 2015. VL tests were conducted in 15 laboratories with different equipment and methods, including RT-PCR, nucleic acid sequence based amplification (NASBA), branched DNA testing (bDNA) and Abbott M2000 RealTime system (M2000). Based on proficiency test for 15 laboratories conducted by National HIV Reference Laboratory, VL test values detected with EasyQ, bDNA and M2000 were converted and standardized into resultant values of TaqMan 2.0. Software SPSS 17.0 was used to produce descriptive statistics for the dataset. Results: From 2014 to 2015, the 15 testing sites were found to use a number of different viral load detection techniques. In 2014, the community viral load values were (2.38±1.47) and (2.99±1.31) in 15 testing sites, while in 2015 these values were found to be (2.07±1.34) and (2.72±1.19). The measurement of community VL was done using standard benchmarks of ≤200 copies/ml, ≤400 copies/ml and ≤1 000 copies/ml, that were used for reference for now. Conclusion: It is necessary to use standard detection method to improve the comparability of annual results. Using a standardized rate of ≤400 copies/ml or ≤1 000 copies/ml for successful control of VL was found with high stability for the result comparison among different areas.

[Development of HIV infection risk assessment tool for men who have sex with men based on Delphi method]

Objective: To develop a HIV infection risk assessment tool for men who have sex with men (MSM) based on Delphi method. Methods: After an exhaustive literature review, we used Delphi method to determine the specific items and relative risk scores of the assessment tool through two rounds of specialist consultation and overall consideration of the opinions and suggestions of 17 specialists. Results: The positivity coefficient through first and second round specialist consultation was 100.0% and 94.1%, respectively. The mean of authority coefficients (Cr) was 0.86. Kendall's W coefficient of the specialist consultation was 0.55 for the first round consultation (χ(2)=84.426, P<0.001) and 0.46 for the second round consultation (χ(2)=65.734, P<0.001), respectively, suggesting that the specialists had similar opinions. The final HIV infection risk assessment tool for MSM has 8 items. Conclusions: The HIV infection risk assessment tool for MSM, developed under the Delphi method, can be used in the evaluation of HIV infection risk in MSM and individualized prevention and intervention. However, the reliability and validity of this risk assessment tool need to be further evaluated.

Ulinastatin Ameliorates Pulmonary Capillary Endothelial Permeability Induced by Sepsis Through Protection of Tight Junctions via Inhibition of TNF-α and Related Pathways

Background: Increased permeability of pulmonary capillary is a common consequence of sepsis that leads to acute lung injury. In this connection, ulinastatin, a urinary trypsin inhibitor (UTI), is used clinically to mitigate pulmonary edema caused by sepsis. However, the underlying mechanism of UTI in alleviating sepsis-associated pulmonary edema remains to be fully elucidated. As tight junctions (TJs) between the pulmonary microvascular endothelial cells (PMVECs) play a pivotal role in the permeability of pulmonary capillary, this study investigated the effect of UTI on expression of junctional proteins in PMVECs during sepsis. Methods: Male adult Sprague Dawley rats were subjected to cecal ligation and puncture (CLP) and divided into sham, CLP, and UTI+CLP groups. UTI was administered every 8 h for 3 days before CLP. At 48 h after surgery, Evans blue (EB) was administered to evaluate the pulmonary vascular leakage. Histological staining was used for evaluation of lung injury score. Using immunofluorescence staining and Western blot, the expression of junctional proteins (occludin, claudin-5, and ZO-1) in pulmonary endothelia was assessed. In vitro, PMVECs were divided into control, lipopolysaccharide (LPS), and UTI+LPS groups for examination of expression of junctional proteins and TNF-α as well as inhibitor of NF-κB (IκB), p38 mitogen-activated protein kinases (p38 MAPKs), c-Jun N-terminal kinases (JNKs), and extracellular signal-regulated kinases (ERKs) signaling pathways. Additionally, the expression of various junctional proteins was determined in PMVECs of control, LPS, and TNF-α receptor antagonist-LPS groups. PMVECs were also treated with TNF-α and TNF-α receptor antagonist and the expression of various junctional proteins was assessed. Results: Compared with the CLP group, UTI markedly decreased EB leakage and lung injury score. The expression of occludin, claudin-5, and ZO-1 was decreased in both CLP rats and LPS-treated PMVECs, but it was reversed by UTI and TNF-α receptor antagonist. TNF-α expression was vigorously elevated in the lung of CLP rats and in LPS-challenged PMVECs, which were suppressed by UTI. In addition, TNF-α also reduced occludin, claudin-5, and ZO-1 expression in PMVECs, but these effects of TNF-α were antagonized by pretreatment with TNF-α receptor antagonist. Furthermore, UTI inhibited LPS-induced activation of NF-κB and mitogen-activated protein kinases (MAPKs) pathways in PMVECs. Conclusion: UTI effectively protects TJs and helps to attenuate the permeability of pulmonary capillary endothelial cells during sepsis through inhibiting NF-κB and MAPKs signal pathways and TNF-α expression.