FeN3S1─OH Single-Atom Sites Anchored on Hollow Porous Carbon for Highly Efficient pH-Universal Oxygen Reduction Reaction.

Regulating the asymmetric active center of a single-atom catalyst to optimize the binding energy is critical but challenging to improve the overall efficiency of the electrocatalysts. Herein, an effective strategy is developed by introducing an axial hydroxyl (OH) group to the Fe─N4 center, simultaneously assisting with the further construction of asymmetric configurations by replacing one N atom with one S atom, forming FeN3S1─OH configuration. This novel structure can optimize the electronic structure and d-band center shift to reduce the reaction energy barrier, thereby promoting oxygen reduction reaction (ORR) and oxygen evolution reaction (OER) catalytic activities. The optimal catalyst, FeSA-S/N-C (FeN3S1─OH anchored on hollow porous carbon) displays remarkable ORR performance with a half-wave potential of 0.92, 0.78, and 0.64 V versus RHE in 0.1 m KOH, 0.5 m H2SO4, and 0.1 m PBS, respectively. The rechargeable liquid Zn-air batteries (LZABs) equipped with FeSA-S/N-C display a higher power density of 128.35 mW cm-2, long-term operational stability of over 500 h, and outstanding reversibility. More importantly, the corresponding flexible solid-state ZABs (FSZABs@FeSA-S/N-C) display negligible voltage changes at different bending angles during the charging and discharging processes. This work provides a new perspective for the design and optimization of asymmetric configuration for single-atom catalysts applied to the area of energy conversion and storage.

"Fence" Effect Enabling a Metal-Organic Framework-Derived Single-Atom Co-N-C Catalyst for High-Performance Zn-Air Batteries.

It offers bright prospects to develop non-Pt group metal (non-PGM) electrocatalysts in the area of energy storage and conversion. Herein, we reported a simple spatial isolation strategy to synthesize Co-based electrocatalysts, using partially substituted Zn atoms in a ZnCo-ZIF precursor. The "fence" effect that originated from the partially substituted Zn atoms can yield a better isolation of Co atoms, achieving selective loading of Co species on nitrogen-doped porous carbon varying from nanoparticles to single atoms. The low boiling point of Zn enables abundant porous structures to the N-doped carbon substrate after pyrolysis. The best performing single-atom Co catalyst (Co-SAs/N-C) exhibits excellent oxygen reduction reaction activity in alkaline media. As an illustration, the rechargeable liquid Zn-air battery incorporating the Co-SAs/N-C catalyst demonstrates a substantial open circuit voltage of 1.49 V, a high specific capacity of 689.3 mAh g-1, and remarkable cycling stability over 200 h. This study paves the way for the strategic development of non-PGM electrocatalysts in battery applications.

Constructing a Self-Supported Bifunctional Multiphase Heterostructure for Electrocatalytic Overall Water Splitting.

Developing well-performing and stable bifunctional electrocatalysts is of great importance for efficient green hydrogen production through water electrolysis. Herein, a three-dimensional self-supported CoMoS3.13/FeS2/Co3S4 on carbon paper (FeCoMoS/CP) heterostructure with interconnected nanosheets for overall water splitting was fabricated by a facile hydrothermal method followed by vulcanization treatment. The FeCoMoS/CP heterostructure with high structural integrity and more accessible active sites can effectively optimize the electronic structure through component regulation to achieve enhanced catalytic activity. Significantly, the FeCoMoS/CP required overpotentials of 257 mV at 50 mA cm-2 for OER and 280 mV at 20 mA cm-2 for HER. Importantly, the assembled FeCoMoS/CP||FeCoMoS/CP alkaline electrolyzer achieved a superior cell voltage of 1.48 V at 10 mA cm-2 with superb long-term stability, which implies a remarkable electrocatalytic performance of the FeCoMoS/CP heterostructure for overall water splitting. This work provides an applicable route for synthesizing high-performance bifunctional catalysts toward water electrolysis.

Multicomponent Interface and Electronic Structure Engineering in Ir-Doped CoMO4-Co(OH)2 (M = W and Mo) Enable Promoted Oxygen Evolution Reaction.

The core principles of multicomponent interface and electronic structure engineering are essential in designing high-performance catalysts for the oxygen evolution reaction (OER). However, combining these aspects within a catalyst is a significant challenge. In this investigation, a novel approach involving the development of hybrid Ir-doped CoMO4-Co(OH)2 (M = W and Mo) hollow nanoboxes was introduced, enabling remarkably efficient water oxidation electrocatalysis. Constructed from ultrathin nanosheet-assembled hollow nanoboxes, these structures boast a wealth of active centers for intermediate species, which in turn enhance both charge transfer and mass transport capabilities. Moreover, the compelling electronic and synergistic effects arising from the interaction between CoMO4 and Co(OH)2 significantly bolster OER electrocatalysis by facilitating efficient electron transfer. The introduction of Ir atoms serves to strategically adjust the electronic structure, fine-tune its electronic state, and operate as active centers to enhance OER electrocatalysis, thus diminishing the overpotential. This configuration results in Ir-CoWO4-Co(OH)2 and Ir-CoMoO4-Co(OH)2 exhibiting impressively low overpotentials of 252 and 261 mV, respectively, to 10 mA cm-2. Utilized in conjunction with the Pt/C catalyst in a two-electrode system for overall water splitting, a mere 1.53 V cell potential is needed to achieve the desired 10 mA cm-2 current density.

3D Hollow Hierarchical Porous Carbon with Fe-N4 -OH Single-Atom Sites for High-Performance Zn-Air Batteries.

The development of innovative and efficient Fe-N-C catalysts is crucial for the widespread application of zinc-air batteries (ZABs), where the inherent oxygen reduction reaction (ORR) activity of Fe single-atom sites needs to be optimized to meet the practical application. Herein, a three-dimensional (3D) hollow hierarchical porous electrocatalyst (ZIF8@FePMPDA-920) rich in asymmetric Fe-N4 -OH moieties as the single atomic sites is reported. The Fe center is in a penta-coordinated geometry with four N atoms and one O atom to form Fe-N4 -OH configuration. Compared to conventional Fe-N4 configuration, this unique structure can weaken the adsorption of intermediates by reducing the electron density of the Fe center for oxygen binding, which decreases the energy barrier of the rate-determining steps (RDS) to accelerate the ORR and oxygen evolution reaction (OER) processes for ZABs. The rechargeable liquid ZABs (LZABs) equipped with ZIF8@FePMPDA-920 display a high power density of 123.11 mW cm-2 and a long cycle life (300 h). The relevant flexible all-solid-state ZABs (FASSZABs) also display outstanding foldability and cyclical stability. This work provides a new perspective for the structural design of single-atom catalysts in the energy conversion and storage areas.

Ultrafine FeF3·0.33H2O Nanocrystal-Doped Graphene Aerogel Cathode Materials for Advanced Lithium-Ion Batteries.

FeF3 has been extensively studied as an alternative positive material owing to its superior specific capacity and low cost, but the low conductivity, large volume variation, and slow kinetics seriously hinder its commercialization. Here, we propose the in situ growth of ultrafine FeF3·0.33H2O NPs on a three-dimensional reduced graphene oxide (3D RGO) aerogel with abundant pores by a facile freeze drying process followed by thermal annealing and fluorination. Within the FeF3·0.33H2O/RGO composites, the three-dimensional (3D) RGO aerogel and hierarchical porous structure ensure rapid diffusion of electrons/ions within the cathode, enabling good reversibility of FeF3. Benefiting from these advantages, a superior cycle behavior of 232 mAh g-1 under 0.1C over 100 cycles as well as outstanding rate performance is achieved. These results provide a promising approach for advanced cathode materials for Li-ion batteries.

Etched High-Entropy Prussian Blue Analogues as Trifunctional Catalysts for Water, Ethanol, and Urea Electrooxidation.

The introduction of high-entropy and high specific surface area into Prussian blue analogues (PBAs) has yet to create interest in the field of electrocatalytic small-molecule oxidation reactions. Herein, we synthesize a novel class of high-entropy (HE) PBAs with a high specific surface area via a simple NH3·H2O-etching strategy and systematically investigate the electrocatalytic performance of HE-PBA toward electrocatalytic water, ethanol, and urea oxidation reactions. Importantly, the NH3·H2O-etched HE-PBA (denoted as HE-PBA-e) demonstrated enhanced electrocatalytic performance toward small-molecule oxidation compared to the pristine HE-PBA, reaching 10 mA cm-2 with potentials of 1.56, 1.41, and 1.37 V for the oxygen evolution reaction (OER), ethanol oxidation reaction (EOR), and urea oxidation reaction (UOR), respectively. Deep characterizations suggest that the NH3·H2O etching treatment not only creates rich nanopores to enlarge the surface area and boosts the mass transport and electron transfer but also facilitates the formation of high-valence metal oxides to improve the intrinsic activity. This demonstration of how systematically increasing the high oxidation state of metals will serve as a governing principle for the rational design of more advanced HE-PBAs toward the electrooxidation of small molecules.

Mechanistic Insights into a Co(II)-Coordinated "Free" Metal Site of 2D Zinc-Based MOFs for ß-Alkylation of Secondary Alcohols with Primary Alcohols.

Through in-depth study of the properties and reaction mechanisms of catalysts, it is possible to better optimize catalytic systems and improve reaction efficiency and selectivity. This remains one of the challenges in the field of catalysis. Therefore, the research and design of catalysts play crucial roles in understanding and optimizing catalytic reaction mechanisms. A robust 2D zinc-based MOFs (Zn-HA) supported Co(II) ion catalyst (Zn-HA@Co) has been designed and synthesized via a coordination-assisted strategy for ß-alkylation of secondary alcohols with primary alcohols. The characterization demonstrated that the anchoring of Co(II) on Zn-HA via coordination could efficiently enhance the Co(II) ion dispersity and interaction between Co(II) and Zn-HA MOFs. Importantly, the density functional theory results have provided mechanistic insights into the energy of the HOMO and LUMO of the Zn-HA@Co catalyst as well as the energy change of the entire process after interacting with the reactants and the specific energy changes of each orbital. The synthesized Zn-HA@Co MOFs effectively lower the energy barrier of the catalytic reaction process. We expect that our research and design of catalysts will serve as valuable guideline for understanding and optimizing catalytic reaction mechanisms.

Lactobacillus fermentum 1.2133 display probiotic potential in vitro and protect against Salmonella pullorum in chicken of infection.

The efficacy of Lactobacillus as an antibiotic substitute has been investigated as one of the potential strategies to prevent Salmonella infection in poultry. The purpose of this study was to explore the antibacterial activity of Lactobacillus fermentum 1.2133 (Lact. fermentum 1.2133) against Salmonella pullorum CVCC533 (Salm. pullorum CVCC533) and its effect on chickens infected with Salm. pullorum CVCC533. Results showed that Lact. fermentans 1.2133 has antibacterial activity against Salm. pullorum CVCC533 and the cell-free fermentation supernatant of Lact. fermentum 1.2133 had a bactericidal effect on the bacteria in the Salm. pullorum CVCC533 biofilm by significantly reducing the number of Salmonella and aerobic bacteria in the chicken duodenum, ileum, and cecum, including Escherichia shigella (P < 0.05), improved the species abundance of Lactobacilli (P < 0.05). The damage to the chicken intestine by Salm. pullorum CVCC533 was reduced as the expression of avian beta-defensin 2 (AvBD2) mRNA in chicken small intestine was increased (P < 0.05). The results showed that Lact. fermentum 1.2133 had the potential to be a probiotic for poultry due to its regulation of intestinal AvBD2 mRNA as well as its intestinal flora.

Novel Positioning Feedback System as a Guidance in Bone Tumor Resection.

Need: Bone resection using customized 3D-printed guides can improve accuracy, but the technique is still associated with clinically significant errors.Technical solution: We developed an inexpensive optical feedback system (OFS) that compares intraoperative 2D camera images to the pre-operative plan, and accurately depicts the surgeon's guide placement prior to cutting, reducing the errors in resection.Proof of concept: We simulated wide resections of a bone sarcoma on 24 cadaver femurs using 3 cutting guide types. Guide placement was measured using the OFS and compared to CT-scans showing the actual guide position. We carried out a second, controlled study on 20 sawbones, comparing the accuracy of the final bone cuts with and without the surgeon actively using the OFS to adjust the guide position before cutting.Results: For cadavers, in 2 of 3 planes, the position of the jig recorded by the OFS closely matched its actual position, with an accuracy of .87° ± .65°(r = .94) and 1.2° ± 1.3°(r = .81) in the transverse and sagittal planes, respectively. In the second study, OFS increased accuracy of the final cut about the transverse and sagittal planes, respectively by 53.1% (P = .011)/54.7% (P = .04) and 33% (P = .051)/38% (P = .042) in terms of rotation and translation.Next steps: Developing the OFS as a mobile application to reduce the processing time and improve accessibility in the operating room.Conclusion: The OFS could accurately depict the guide placement on the bone and significantly improve the surgical accuracy of 3D printed jigs.

Cerebral perfusion alterations in type 2 diabetes mellitus - a systematic review.

Type 2 diabetes mellitus (T2DM) is related to abnormal brain structure and function, increasing the risk of cognitive impairment and dementia. We systematically reviewed the published literature focusing on cerebral perfusion in patients with T2DM. Although no significant difference was found in global cerebral blood flow (CBF) between the T2DM group and the healthy control group, the regional cerebral perfusion in T2DM was significantly reduced in multiple locations, including the occipital lobe, domains involved in the default mode network and the cerebellum. The decline in regional CBF was associated with a wide range of cognitive disorders in T2DM, including learning, memory, attention, and executive processing, as well as visual function. In addition, diabetes-related biochemical indicators, such as glycated hemoglobin and insulin resistance, were negatively correlated with regional CBF. In general, these functional perfusion imaging studies indicate that decreased CBF in T2DM may be a potential cause of cognitive impairment.

Peripapillary vessel density correlates with visual field mean sensitivity in highly myopic eyes.

PURPOSE: To identify the global and regional distribution of peripapillary vessel density (pVD) and try to find out the relationships between pVD and the visual field mean sensitivity (VFMS) in healthy myopic eyes. DESIGN: Prospective cross-sectional study. METHODS: Two hundred and twenty-two participants (393 eyes) with myopia (myopic refractive error < - 0.5 diopters) from two clinical centers were recruited in this study and were divided into 4 groups according to the spherical equivalent (SE): Group1:- 0.5D ≥ SE > - 6.00D, Group2: - 6.00D ≥ SE > - 8.00D, Group3:- 8.00D ≥ SE > - 10.00D, Group4:SE ≤ -10.00D.The pVD assessed with optical coherence tomography angiography (OCTA) was quantified in 8 sectors. Peripapillary retinal nerve fibre layer (pRNFL) imaging was performed with SD-OCT. Visual field (VF) tests were performed with the 30-2 SITA standard program on the Humphrey 750i Visual Field Analyzer and were grouped into 8 regions that matched the structure. RESULTS: The pRNFL had no significant difference in all groups (p = 0.422). The average pVD were significantly lower in group 4 (47.61 ± 6.58) than in group 2 and 3 (51.49 ± 3.21, 50.48 ± 3.43 respectively) (p < 0.05). While both pVD in group2 and 3 were statistically lower than group1 (52.77 ± 2.86). The average VFMS was significantly lower in group 4 (901.85 ± 386.54) than other three groups (1169.15 ± 328.94, 1081.77 ± 338.83, 1076.89 ± 358.18, for group1,2,3 respectively). The pVD and VFMS were positively correlated in group3 (r = 0.184) and group4 (r = 0.476) (p < 0.05). Linear regression analysis demonstrated that VFMS were positively associated with pVD especially in temporal and nasal quadrants in myopic eyes. CONCLUSIONS: The pVD shows a significant positive correlation with VFMS in highly myopic eyes with SE ≤ - 8.00D. We suggest that pVD measurement by OCTA could be a sensitive and useful method for monitoring myopic functional change.

Antidiabetic medications and the risk of prostate cancer in patients with diabetes mellitus: A systematic review and meta-analysis.

BACKGROUND: Antidiabetic medications (ADMs) may modify prostate cancer (PCa) risk in patients with diabetes mellitus (DM). Accordingly, the current study assessed the possible associations between ADMs and the risk of PCa in diabetics. METHODS: A systematic literature search (PubMed, Embase and Cochrane Library) identified studies evaluating the associations between ADMs and incidence of PCa. A meta-analysis followed PRISMA was performed using odds ratio (OR) with 95% confidence interval (CI) as effect measures. RESULTS: In total of 47 studies involving 3094,152 patients with diabetes were included. Results of meta-analysis of the observational studies suggested no significant association between metformin, thiazolidinediones, sulfonylureas, insulin or dipeptidyl peptidase-4 inhibitors administration and the risk of PCa (All p-values > 0.05). Separate analysis of randomized controlled trials (RCTs) revealed a significant reduction in PCa risk with thiazolidinediones (OR = 0.55, p = 0.04) or glucagon-like peptide-1 receptor agonists (GLP-1RA) administration (OR = 0.53, p = 0.006), whereas no significant association was found in SGLT2 inhibitors (p = 0.3). CONCLUSION: Thiazolidinediones or GLP-1RA administration may have benefits in PCa based on RCTs, however, further research is needed to confirm these findings.

Hierarchical Hollow CoWO4-Co(OH)2 Heterostructured Nanoboxes Enabling Efficient Water Oxidation Electrocatalysis.

Rational design and construction of well-defined hollow heterostructured nanomaterials assembled by ultrathin nanosheets overtakes crucial role in developing high-efficiency oxygen evolution reaction (OER) electrocatalysts. Herein, a reliable metal-organic framework-mediated and cation-exchange strategy to tune the geometric structure and multicomponent heterostructures has been proposed for the fabrication of hollow CoWO4-Co(OH)2 hierarchical nanoboxes assembled by rich ultrathin nanosheets. Benefiting from the hierarchical hollow nanostructure, the CoWO4-Co(OH)2 nanoboxes offer plenty of metal active centers available for reaction intermediates. Moreover, the well-defined nanointerfaces between CoWO4 and Co(OH)2 can function as the bridge for boosting the efficient electron transfer from CoWO4 to Co(OH)2. As a consequence, the optimized CoWO4-Co(OH)2 nanoboxes can exhibit outstanding electrocatalytic performance toward OER by delivering 10 mA cm-2 with a low overpotential of 280 mV and a small Tafel slope of 70.6 mV dec-1 as well as outstanding electrochemical stability. More importantly, this CoWO4-Co(OH)2 heterostructured nanocatalyst can couple with Pt/C to drive overall water splitting to achieve 10 mA cm-2 with a voltage of 1.57 V.

Engineering Heterostructured Pd-Bi2Te3 Doughnut/Pd Hollow Nanospheres for Ethylene Glycol Electrooxidation.

The electrooxidation of ethylene glycol (EG) is of vital significance for the conversion from biomass energy into electrical energy via direct fuel cells. However, the EG oxidation reaction (EGOR) suffers from poor efficiency due to the limitation of high-performance electrocatalysts for cleaving the C-C bonds. Herein, this limitation is successfully addressed by fabricating the doughnut-shaped Pd-Bi2Te3 heterostructured catalyst. Notably, the heterojunction Pd-Bi2Te3 nanocatalyst has been demonstrated to be highly active toward the EGOR with superb activity and durability, in which a mass activity as high as 2420.8 mA mg-1 is achieved in alkaline media, being 1.7 times higher than that of the commercial Pd/C catalyst. Upon combination of experimental results with mechanism studies, it is indicated that the remarkable EGOR performance is attributed to the enlarged active areas that stemmed from the doughnut-like structure, as well as the strong synergistic effect from Pd-Bi2Te3 and Pd. More importantly, the highly electroactive Pd-Bi2Te3 can accelerate charge transfer and boost the oxidation of CO-like intermediates, which are conducive to the enhancement in electrochemical stability.

Successive Anion/Cation Exchange Enables the Fabrication of Hollow CuCo2S4 Nanorods for Advanced Oxygen Evolution Reaction Electrocatalysis.

Hollow CuCo2S4 nanorods (H-CCS-Ns) have been successfully developed via a facile successive anion/cation-exchange method. The outstanding electrocatalytic performance of H-CCS-Ns is mainly attributed to its distinctive hollow structure, which accelerates the electron transfer rate and provides abundant active sites. Moreover, a mechanism study indicates that H-CCS-Ns has highly active octahedral Co3+, and the existence of Co3+ cations optimizes the adsorption of oxygen-involved intermediates, making H-CCS-Ns a promising OER electrocatalyst. Optimized H-CCS-Ns only need an ultralow overpotential of 220 mV to drive a current density of 10 mA·cm-2 and exhibit distinguished cycling stability with a negligible fluctuation for 30 h. More impressively, when H-CCS-Ns are assembled with Pt/C for overall water splitting, a voltage as low as 1.545 V is required at a current density of 10 mA·cm-2, and the catalyst shows outstanding stability for as long as 38 h. This study offers a feasible strategy to design hollow spinel catalysts for efficient OER catalysis.

A facile solvothermal syntheses of NiFe layered double hydroxide-Bi2MoO6 heterostructure/reduced graphene oxide with efficient photodegradation for tetracycline.

A heterojunction of NiFe layered double hydroxide (NiFe LDH)-Bi2MoO6 (BMO) loaded on reduced graphene oxide (RGO) sheets was synthesized via an eco-friendly solvothermal reaction. The structural characterization shows that NiFe LDH-BMO heterojunctions are well-distributed on the surface of silk-like transparent RGO sheets. The modification of BMO by NiFe LDH and RGO greatly enhances the photocatalytic performance of BMO for degradation of tetracycline (TC) under visible light. The photocatalyst prepared with 3 wt% RGO shows the highest activity and cycle stability. TC can be completely removed in 80 min, which is about 8.7 times that pure BMO, and showing excellent reusability even after five cycles. The excellent enhancement of photocatalytic performance of NiFe LDH-BMO/RGO composite is attributed to the unique sheet-on-sheet hierarchical heterostructure combined with RGO sheets, facilitating the visible light absorption and photogenerated charge carriers separation.

Distributed Random Beacon for Blockchain Based on Share Recovery Threshold Signature.

Random beacons play a crucial role in blockchains. Most random beacons in a blockchain are performed in a distributed approach to secure the generation of random numbers. However, blockchain nodes are in an open environment and are vulnerable to adversary reboot attacks. After such an attack, the number of members involved in a random number generation decreases. The random numbers generated by the system become insecure. To solve this problem while guaranteeing fast recovery of capabilities, we designed a threshold signature scheme based on share recovery. A bivariate polynomial was generated among the participants in the distributed key generation phase. While preserving the threshold signature key share, it can also help participants who lost their shares to recover. The same threshold setting for signing and recovery guarantees the security of the system. The results of our scheme show that we take an acceptable time overhead in distributed key generation and simultaneously enrich the share recovery functionality for the threshold signature-based random number generation scheme.

Rational design of nano-Fe3O4encapsulated in 3D honeycomb biochar for enhanced lithium storage performance.

Developing green materials applied in lithium-ion batteries is of significant importance for the present-day society. Herein, a feasible strategy to construct Fe3O4nanoparticles (NPs) embedded in three-dimensional (3D) honeycomb biochar derived from pleurotus eryngii was proposed. The obtained material consists of Fe3O4NPs (35-85 nm) encapsulated in 3D honeycomb biochar possesses a high specific capacity of 723 mAh g-1at 1.5 A g-1after 1000 cycles. The effectively enhanced cycling life of Fe3O4@C nanocomposites can be ascribed to the small Fe3O4NPs provide lower degree of cracking and high specific capacity, while the honeycomb biochar function like a cage to inhibit huge volume change of Fe3O4NPs during the charge-discharge process.

Diabetes mellitus coexisted with progeria: a case report of atypical Werner syndrome with novel LMNA mutations and literature review.

Werner syndrome (WS) is a rare, adult-onset progeroid syndrome. Classic WS is caused by WRN mutation and partial atypical WS (AWS) is caused by LMNA mutation. A 19-year-old female patient with irregular menstruation and hyperglycemia was admitted. Physical examination revealed characteristic faces of progeria, graying and thinning of the hair scalp, thinner and atrophic skin over the hands and feet, as well as lipoatrophy of the extremities, undeveloped breasts at Tanner stage 3, and short stature. The patient also suffered from severe insulin-resistant diabetes mellitus, hyperlipidemia, fatty liver, and polycystic ovarian morphology. Possible WS was considered and both WRN and LMNA genes were analyzed. A novel missense mutation p.L140Q (c.419T>A) in the LMNA gene was identified and confirmed the diagnosis of AWS. Her father was a carrier of the same mutation. We carried out therapy for lowering blood glucose and lipid and improving insulin resistance, et al. The fasting glucose, postprandial glucose and triglyceride level was improved after treatment for 9 days. Literature review of AWS was performed to identify characteristics of the disease. Diabetes mellitus is one of the clinical manifestations of WS and attention must give to the differential diagnosis. Gene analysis is critical in the diagnosis of WS. According to the literature, classic and atypical WS differ in incidence, pathogenic gene, and clinical manifestations. Characteristic dermatological pathology may be significantly more important for the initial identification of AWS. Early detection, appropriate treatments, and regular follow-up may improve prognosis and survival of WS patients.