Hb Hebei [α20 (B1) His→Leu; HBA2:C.62A > T]: A Novel Hemoglobin Variant Found during Measurement of Glycated Hemoglobin.

We report a novel hemoglobin (Hb) variant found in a 34-year-old Chinese male during a routine measurement of glycated hemoglobin. The variant resulted in a P3 peak of 27.5% of the total Hb on high performance liquid chromatography (HPLC) with a glycated hemoglobin mode. However, no abnormal Hb peaks were observed in capillary electrophoresis (CE) with 3.1% Hb A2 and 96.9% Hb A. The amino acid substitution was determined by Sanger sequencing as α20 (B1) His→Leu; the corresponding DNA mutation was identified as CAC > CTC at the first position of codon 20 of the α-chain. This is the first description of the mutation, and we have named it Hb Hebei for the region of origin of the proband.

Prediction of axillary lymph node metastasis in early breast cancer patients with ultrasonic videos based deep learning.

Objective: To develop a deep learning (DL) model for predicting axillary lymph node (ALN) metastasis using dynamic ultrasound (US) videos in breast cancer patients. Methods: A total of 271 US videos from 271 early breast cancer patients collected from Xiang'an Hospital of Xiamen University andShantou Central Hospitabetween September 2019 and June 2021 were used as the training, validation, and internal testing set (testing set A). Additionally, an independent dataset of 49 US videos from 49 patients with breast cancer, collected from Shanghai 10th Hospital of Tongji University from July 2021 to May 2022, was used as an external testing set (testing set B). All ALN metastases were confirmed using pathological examination. Three different convolutional neural networks (CNNs) with R2 + 1D, TIN, and ResNet-3D architectures were used to build the models. The performance of the US video DL models was compared with that of US static image DL models and axillary US examination performed by ultra-sonographers. The performances of the DL models and ultra-sonographers were evaluated based on accuracy, sensitivity, specificity, and area under the receiver operating characteristic curve (AUC). Additionally, gradient class activation mapping (Grad-CAM) technology was also used to enhance the interpretability of the models. Results: Among the three US video DL models, TIN showed the best performance, achieving an AUC of 0.914 (95% CI: 0.843-0.985) in predicting ALN metastasis in testing set A. The model achieved an accuracy of 85.25% (52/61), with a sensitivity of 76.19% (16/21) and a specificity of 90.00% (36/40). The AUC of the US video DL model was superior to that of the US static image DL model (0.856, 95% CI: 0.753-0.959, P<0.05). The Grad-CAM technology confirmed the heatmap of the model, which highlighted important subregions of the keyframe for ultra-sonographers' review. Conclusion: A feasible and improved DL model to predict ALN metastasis from breast cancer US video images was developed. The DL model in this study with reliable interpretability would provide an early diagnostic strategy for the appropriate management of axillary in the early breast cancer patients.

[Effects of Short-Term Nitrogen and Phosphorus Addition on Soil Respiration Components in a Subalpine Grassland of Qilian Mountains].

In order to investigate the effects of short-term nitrogen and phosphorus addition on soil respiration and its components in a subalpine grassland located on the Qilian Mountains, a random block design of nitrogen[10 g·(m2·a)-1, N], phosphorus[5 g·(m2·a)-1, P], nitrogen and phosphorus addition[10 g·(m2·a)-1N and 5 g·(m2·a)-1P, NP], the control (CK), and complete control (CK') was conducted from June to August 2019, and total soil respiration and its component respiration rates were measured. The results showed that nitrogen addition reduced soil total respiration and heterotrophic respiration rates at a lower rate than P addition[-16.71% vs. -19.20%; -4.41% vs. -13.05%], but the rate of decrease in autotrophic respiration was higher than that of P addition (-25.03% vs. -23.36%); N and P mixed application had no significant effect on soil total respiration rate. The total soil respiration rate and its components were significantly exponentially correlated with soil temperature, and the temperature sensitivity of soil respiration rate was decreased by nitrogen addition (Q10:-5.64%-0.00%). P increased Q10 (3.38%-6.98%), and N and P reduced autotrophic respiration rate but increased heterotrophic respiration rate Q10 (16.86%) and decreased total soil respiration rate Q10 (-2.63%- -2.02%). Soil pH, soil total nitrogen, and root phosphorus content were significantly correlated with autotrophic respiration rate (P<0.05) but not with heterotrophic respiration rate, and root nitrogen content was significantly negatively correlated with heterotrophic respiration rate (P<0.05). In general, autotrophic respiration rate was more sensitive to N addition, whereas heterotrophic respiration rate was more sensitive to P addition. Both N and P addition significantly reduced soil total respiration rate, whereas N and P mixture did not significantly affect soil total respiration rate. These results can provide a scientific basis for the accurate assessment of soil carbon emission in subalpine grassland.

Comparative efficacy of anti-epileptic drugs for neonatal seizures: A network meta-analysis.

BACKGROUND: Anti-epileptic drugs have different effects on neonatal seizures, and new agents have been widely used in recent years. Meanwhile, significant differences still exist in the treatment for neonatal seizures, whether in choice of drug or in duration of treatment. And with the increase in options for treatment, the best choice of second-line treatment has not been recommended. METHODS: The MEDLINE, the Cochrane Library, Web of Science, Embase and clinicaltrials.gov databases were searched (January 1, 1960 to October 20, 2020). Randomized controlled trials (RCTs) or observational investigations studying anti-epileptic drugs for neonatal seizures were selected. And then we conducted a network meta-analysis and examined comparative efficacy of the first-line and second-line anti-epileptic drugs for neonatal seizures. RESULTS: Data were extracted from 11 included studies by 2 independent investigators. Random effects models were used to estimate odds ratios (ORs). We performed direct meta-analyses with a random effects model and network meta-analyses for first-line and second-line drugs. Five published RCTs and 6 observational investigations with 1333 patients and 6 interventions contributed to the analysis. CONCLUSION: We recommend phenobarbital as the first-line drug for neonatal seizures. In addition, there is a tendency for levetiracetam to be an effective second-line treatment for neonatal seizures after failure of first-line drugs.

[Effect of acupuncture on pattern visual evoked potential of cerebral visual impairment in children aged 3-10 years].

OBJECTIVE: To observe clinical effect of acupuncture combined with conventional visual stimulation on cerebral visual impairment (CVI) in children aged 3-10 years and influence on the pattern visual evoked potential (P-VEP). METHODS: A total of 60 cases of children aged 3-10 years with CVI were randomly divided into an observation group and a control group, 30 cases in each group. The children in the control group received conventional visual stimulation therapy, 1 month as a course of treatment. On the basis of the control group, the children in the observation group was treated with acupuncture at Baihui (GV 20), Jingming (BL 1), Taiyang (EX-HN 5), Sibai (ST 2), etc. 3 times a week, and the treatment was given 4 weeks continuously as a course. Both groups received 3 courses of treatment. The visual acuity and P-VEP improvement were compared between the two groups before and after treatment. RESULTS: After treatment, the incubation period (P100-L) of the two groups was shorter than before treatment, and the amplitude (P100-A) was higher than before treatment (P<0.05); and the degree of above changes in the observation group was lager than the control group (P<0.05). The percentage of best corrected visual acuity of 0.6-0.8 in the observation group after treatment and follow-up 1 year after treatment was higher than before treatment (P<0.05), and was higher than the control group (P<0.05). CONCLUSION: Acupuncture combined with conventional visual stimulation can improve the incubation period (P100-L) and amplitude (P100-A) of P-VEP in children with CVI, and improve the best corrected visual acuity in children, the clinical effect is better than the conventional visual stimulation alone.

How to Early Identify and Prevent the SARS-CoV-2 Infection in Children for Families?

Importance: COVID-19 has become a worldwide pandemic. Many countries have reported cases of infection in children and newborns, and there is a trend of significantly increasing infections among these populations. Therefore, it is important to provide advice and guidance for the prevention and control of COVID-19 in children. Observations: Children are as susceptible to SARS-CoV-2 infection as adults. The manifestations in children are atypical, and children are much less likely to have critical cases. If children are infected, they may play an important role in the spread of SARS-CoV-2 because their symptoms are less obvious and less likely to be detected. To prevent COVID-19 from spreading among children, efforts to prevent, and control the infection should be increased by controlling the source of infection, blocking the route of transmission and protecting the susceptible population. Conclusions and Relevance: The early identification of the COVID-19 in children and the protection of families are important measures to prevent the continued spread of SARS-CoV-2.

Analysis and predication of tuberculosis registration rates in Henan Province, China: an exponential smoothing model study.

BACKGROUND: The World Health Organization End TB Strategy meant that compared with 2015 baseline, the reduction in pulmonary tuberculosis (PTB) incidence should be 20 and 50% in 2020 and 2025, respectively. The case number of PTB in China accounted for 9% of the global total in 2018, which ranked the second high in the world. From 2007 to 2019, 854 672 active PTB cases were registered and treated in Henan Province, China. This study was to assess whether the WHO milestones could be achieved in Henan Province. METHODS: The active PTB numbers in Henan Province from 2007 to 2019, registered in Chinese Tuberculosis Information Management System were analyzed to predict the active PTB registration rates in 2020 and 2025, which is conductive to early response measures to ensure the achievement of the WHO milestones. The time series model was created by monthly active PTB registration rates from 2007 to 2016, and the optimal model was verified by data from 2017 to 2019. The Ljung-Box Q statistic was used to evaluate the model. The statistically significant level is α = 0.05. Monthly active PTB registration rates and 95% confidence interval (CI) from 2020 to 2025 were predicted. RESULTS: High active PTB registration rates in March, April, May and June showed the seasonal variations. The exponential smoothing winter's multiplication model was selected as the best-fitting model. The predicted values were approximately consistent with the observed ones from 2017 to 2019. The annual active PTB registration rates were predicted as 49.1 (95% CI: 36.2-62.0) per 100 000 population and 34.4 (95% CI: 18.6-50.2) per 100 000 population in 2020 and 2025, respectively. Compared with the active PTB registration rate in 2015, the reduction will reach 23.7% (95% CI, 3.2-44.1%) and 46.8% (95% CI, 21.4-72.1%) in 2020 and 2025, respectively. CONCLUSIONS: The high active PTB registration rates in spring and early summer indicate that high risk of tuberculosis infection in late autumn and winter in Henan Province. Without regard to the CI, the first milestone of WHO End TB Strategy in 2020 will be achieved. However, the second milestone in 2025 will not be easily achieved unless there are early response measures in Henan Province, China.

Intranasal IL-4 Administration Alleviates Functional Deficits of Periventricular Leukomalacia in Neonatal Mice.

Background: Periventricular leukomalacia (PVL) is the major form of brain injury in premature infants. Currently, there are no therapies to treat PVL. Several studies suggested that polarization of microglia, a resident macrophage-like immune cell in the central nervous system, plays a vital role in brain injury and recovery. As an important mediator of immunity, interleukin-4 (IL-4) has critical effects on many immune cells, such as astrocytes and microglia. Increasing evidence shows that IL-4 plays a well-established role in attenuating inflammation in neurological disorders. Additionally, as a noninvasive and highly effective method, intranasal drug administration is gaining increasing attention. Therefore, in our study, we hypothesized that intranasal IL-4 administration is a promising strategy for PVL treatment. Methods: The therapeutic effects of IL-4 on neuroprotection were evaluated using a Control group, Hypoxia group, and Hypoxia + IL-4 treatment group. The PVL mouse model was established by a severe acute hypoxia (SAH) protocol. Exogenous IL-4 was intranasally administered to investigate its neuroprotective effects. A functional study was used to investigate neurological deficits, immunohistochemical technology and Western blotting were used to detect protein levels, and electron microscopy was used to evaluate myelination. Results: The results suggested that hypoxia stimulated Iba1+ microglial activation, downregulated myelin-related gene (NG2, MAG, and MBP) expression, reduced MBP protein levels, and caused neurological deficits. However, the intranasal administration of exogenous IL-4 partially inhibited Iba1+ microglial activation, improved myelination, and alleviated neurological deficits. The mechanistic study showed that IL-4 improved myelination possibly through the IL-4Ra-mediated polarization of microglia from the M1 phenotype to the M2 phenotype. Conclusion: In summary, our findings demonstrated that the intranasal administration of exogenous IL-4 improves myelination and attenuates functional deficits in a hypoxia-induced PVL model. Intranasal IL-4 administration may be a promising strategy for PVL treatment, for which further mechanistic studies are urgent.

[Effects of nitrogen addition on tree root traits.] / æ°®æ·»åŠ å¯¹æ ‘æœ¨æ ¹ç³»ç‰¹æ€§çš„å½±å“.

Atmospheric nitrogen deposition has complex effects on individual plants and terrestrial ecosystems. We synthesized results from 39 published papers (16 papers in English and 23 papers in Chinese) and conducted a meta-analysis to evaluate the general responses of tree root traits to nitrogen addition, and further analyzed the difference of N-induced results between English papers and Chinese papers. Our results showed that N addition significantly increased fine root diameter (+6.7%), fine root N content (+8.9%), and root respiration rate (+17.5%), but did not affect fine root biomass, fine root length, specific root length, fine root C content, and fine root C:N ratio. Different climatic zone and fertilizer types had different effects on the experimental results. In addition, experimental results published in English papers were generally more significant than those in Chinese papers. We summarized the general effects of N addition on tree root systems, and further analyzed the mechanisms underlying the effects of N enrichment on forest ecosystem carbon cycle.

Transthoracic Echocardiographic Evaluation of Pulmonary Valve Anomalies in Pediatric Patients.

The pulmonary valve normally consists of 3 leaflets supported in a semilunar fashion within the sinuses of the pulmonary trunk. Pulmonary leaflet malformations, such as congenital single pulmonary cusp absence, bicuspid pulmonary valve, and quadricuspid pulmonary valve anomalies, as well as pulmonary valve commissural fusion, are seldom identified preoperatively on echocardiography. In this study, we report on 5 children with different types of pulmonary valve malformations diagnosed by transthoracic echocardiography.

Influence of microstructural features on thermal expansion coefficient in graphene/epoxy composites.

In this paper, theoretical calculations were conducted to determine the coefficient of thermal expansion (CTE) based on the effective medium approach using Green's function method. The influences of microstructural features were investigated, including volume fraction, aspect ratio, and the orientation of graphene fillers. Calculated results demonstrated strong anisotropy of CTE when all graphene sheets in the composite were aligned in the in-plane direction due to the large difference between the elastic moduli of the graphene and epoxy. The in-plane CTE in the graphene/epoxy composite can be effectively reduced with small additions of graphene additive. Orientation dispersion among the graphene fillers significantly decreases the anisotropy of CTE. Accounting for the influences of all microstructural features, simulation results closely align with current experimental results. This work will provide a general guideline and a solid foundation for the optimal design and preparation of graphene/polymer composites.

[Applicability of daytime downward longwave radiation parameterized models in Changbai Mountains, Northeast China].

A total of eight clear-sky and eight cloudy-sky parameterized models for estimating daytime downward longwave radiation were evaluated by using the meteorological data measured in the Changbai Mountains region, Northeast China. The results indicated that the Satterlund model performed better in estimating clear-sky downward longwave radiation, and the bias (BIAS) and root mean square error (RMSE) were -23.34 and 28.55 W· m(-2), respectively. Although the coefficients were not significantly changed, the performance of Satterlund model was significantly improved after the locally calibrated, and the BIAS and RMSE decreased to -6.33 and 18.08 W · m(-2), respectively. Jacobs model was found to be best for modeling cloudy-sky downward long-wave radiation and the BIAS and RMSE were 0.38 and 29.29 W · m(-2), respectively. Sensitivity analysis showed that the vapor pressure was the most sensitive variable to the atmospheric emissivity and the temperature was not sensitive to it. The predicted results of the optimal model (clear- and cloudy-sky) were consistent with the measured data, while the performance of these models was affected by a sudden change of cloudy cover.

Factors associated with primary transmission of multidrug-resistant tuberculosis compared with healthy controls in Henan Province, China.

BACKGROUND: It is estimated that there are about 74,000 primary multidrug-resistant tuberculosis (MDR-TB) patients per year according to the prevalence of MDR-TB of 5.7% among new TB patients in China. Thus, the risks of primary transmission of MDR-TB require further attention. This study aimed to identify the factors associated with primary transmission of MDR-TB in Henan province, where the number of new TB patients is ranked second highest in China. METHODS: A 1:1 matched case-control study was conducted in Henan, China. Cases were primary MDR-TB patients who were individually matched with a healthy control without TB from the same neighborhood. The study was conducted from July 2013 to June 2014. Both case and control were matched by age (±5 years) and sex. Conditional logistic regression was used to compute adjusted odds ratios (AORs) with corresponding 95% confidence intervals (CIs) for risk factors associated with primary MDR-TB. RESULTS: For the study, 146 pairs of participants were recruited. The final multivariable logistic regression model disclosed that after adjusting for age and sex, primary MDR-TB cases were more likely to be single (AOR, 5.4; 95% CI, 1.4-20.7), earn an annual income of ≤ 12,000 yuan (RMB) (AOR, 9.9; 95% CI, 2.0-48.1), experience more life pressure/stress (AOR, 10.8; 95% CI, 2.8-41.5), not be medically insured (AOR, 50.1; 95% CI, 8.2-306.8), and suffer from diabetes, cardiovascular disease or other respiratory diseases, or cancer (AOR, 57.1; 95% CI, 8.6-424.2). CONCLUSIONS: In order to control primary transmission of MDR-TB in China, we recommend that improving the social support, living standards and medical security of the lower social class become a priority.

Effects of Fluoride on DNA Damage and Caspase-Mediated Apoptosis in the Liver of Rats.

Fluoride compounds are abundant and widely distributed in the environment at a variety of concentrations. Further, fluoride induces toxic effects in target organs such as the liver. In this study, we investigated liver histopathology, DNA damage, apoptosis, and the mRNA and protein expressions of caspase-3 and -9 in the rat livers by administering varying concentrations of fluoride (0, 50, 100, 200 mg/L ) for 120 days. The results showed fluoride-induced morphological changes and significantly increased apoptosis and DNA damage in rats exposed to fluoride, especially in response to higher doses. The immunohistochemical and qRT-PCR results indicated that caspase-3, caspase-9 protein positive expression and mRNA relative expression enhanced with increasing NaF concentration. In summary, our findings suggest that chronic exposure to fluoride causes damages to liver histopathology and leads to liver apoptosis through caspase-mediated pathways.

Clinical and radiographic predictors in diagnosing sputum smear-negative pulmonary tuberculosis in HIV-negative patients: a cross-sectional study in China.

BACKGROUND: In county-level tuberculosis (TB) dispensaries in China, the accurate diagnosis of sputum smear-negative pulmonary tuberculosis (SNPT) needs to be improved by developing and validating clinical and radiographic predictors. METHODS: The study was conducted simultaneously in three counties per province in Chongqing Municipality and Liaoning Province in China between May 2005 and May 2006. A total of 432 new SNPT patients who are HIV-negative and more than 15 years old diagnosed by expert panels in county-level TB dispensaries were recruited. Their sputum samples were collected for culture before anti-TB treatment, and the treatment outcomes (changes of X-rays) were followed up at the end of the 6th month. RESULTS: Of the 432 SNPT patients, sputum culture positive (9.7%) or culture negative with good changes of X-rays at the end of the 6th month (73.6%) was validated as SNPT. Four predictive variables were associated with validated SNPT in the multivariate logistic regression model: age ≤55 years old (odds ratio (OR) 5.66; 95% CI 2.69-11.91), >60 days of cough (OR 3.73; 95% CI 1.10-12.65), ≥10% of pulmonary consolidation in the lungs (OR 5.40; 95% CI 2.90-10.06), and pulmonary consolidation in the upper lobe anterior segment (OR 3.00; 95% CI 1.57-5.72). The area under the receiver operating characteristic curve of the model was 0.77 (95% CI 0.71-0.83). CONCLUSION: Four predictors of clinical and radiological characteristics that had a good diagnostic performance of SNPT deserve to be recommended as index indicators of SNPT diagnosis in county-level TB dispensaries in China.