Necrotizing enterocolitis in a term newborn after spontaneous cerebral parenchymal hemorrhage: a case report.

BACKGROUND: Necrotizing enterocolitis (NEC) and intracranial hemorrhage are severe emergencies in the neonatal period. The two do not appear to be correlated. However, our report suggests that parenchymal brain hemorrhage in full-term newborns may put patients at risk for NEC by altering intestinal function through the brain-gut axis. CASE PRESENTATION: We present a case of spontaneous parenchymal cerebral hemorrhage in a full-term newborn who developed early-stage NEC on Day 15. CONCLUSIONS: It is possible to consider brain parenchymal hemorrhage as a risk factor for the appearance of NEC. Clinicians should be highly cautious about NEC in infants who have experienced parenchymal hemorrhage. This article is the first to discuss the relationship between parenchymal hemorrhage and NEC in full-term newborns.

Long-term outcomes of endovascular therapy for right subclavian artery occlusive lesions: A multi-center experience.

OBJECTIVE: To review our multi-institutional experience with endovascular therapy for right subclavian artery occlusive disease and to evaluate the long-term outcomes. METHODS: We retrospectively evaluated all patients with right subclavian artery stenosis and occlusive disease who underwent endovascular therapy between March 2014 and September 2022 at two institutions. Patient baseline demographics, lesion characteristics, treatment strategies, and in-hospital and follow-up outcomes were prospectively collected and retrospectively analyzed. RESULTS: Between March 2014 and September 2022, 73 patients underwent endovascular treatment at the two institutions. The dominant cause of lesions in this cohort was atherosclerosis. Three different types of lesions were summarized, and the corresponding endovascular strategies were performed. 66 patients (90.4%) underwent successful endovascular treatment, and 62 patients (84.9%) underwent balloon-expandable stent deployment. The mean perioperative in-hospital stay was 4.0 days (range, 3-6 days). Two patients died due to myocardial infarction, and one died of cerebral hemorrhage resulting from a traffic accident within 30 days of the intervention. The median follow-up time was 31.6 months (range, 12-96 months). No complications, including death, stroke, stent fractures, or migration, were noted in any patient during the follow-up period. The overall complication rate was 7/73 (9.6%), and 5/7 (6.9%) of the complications required reintervention. CONCLUSIONS: Endovascular treatment of right subclavian artery lesions is safe, effective, and technically achievable. The reasonable use of balloon-expandable stents can achieve satisfactory outcomes with accurate orientation and promising patency.

Long-term outcomes of thoracic endovascular aortic repair for chronic Stanford type B aortic dissection.

OBJECTIVES: The aim of this study was to report the long-term outcomes of proximal thoracic endovascular aortic repair (TEVAR) for chronic Stanford type B aortic dissection (cTBAD). METHODS: We retrospectively analyzed the clinical data of 48 cases of patients with cTBAD who underwent proximal TEVAR in Zhongshan Hospital Fudan University from January 2010 to September 2013. The preoperative and postoperative imaging examinations, overall survival rate, aortic-related survival rate, and freedom from reintervention rate data were collected to evaluate aortic remodeling and clinical outcomes. The enrolled patients received follow-up at 1, 3, 6, and 12 months following treatment and annually thereafter. RESULTS: A total of 48 patients (mean age, 58.3 ± 10.6 years; men:women, 40:8) were included, of which 38 cases (79.2%) were uncomplicated dissection and 10 cases (20.8%) were complicated. The mean follow-up time was 48.7 ± 40 months (1-120 months). The mean time interval from the initial procedure to reintervention was 50.6 ± 32.7 months (11-98 months). The following changes were observed at preoperative versus last follow-up timepoints. Descending aortic level: true lumen, 19.2 ± 7.01 mm vs. 36.9 ± 9.53 mm (p < 0.001); false lumen, 30.47 ± 15.89 mm vs. 19.16 ± 15.33 mm (p < 0.001); maximum diameter, 49.67 ± 13.96 mm vs. 56.66 ± 14.95 mm (p = 0.018). Diaphragm level: true lumen, 16.24 ± 5.41 mm vs. 24.41 ± 8.04 mm (p < 0.001); false lumen, 12.37 ± 11.49 mm vs. 14.92 ± 12.25 mm (p = 0.196); and maximum diameter, 34 ± 7.81 mm vs. 38.04 ± 7.7 mm (p < 0.001). The freedom from reintervention rate was 81% in 5 years and 50.6% in 10 years. The overall 10-years survival rate was 83% (6 of 48), and the aortic-related survival rate was 92.3% (3 of 48). CONCLUSIONS: TEVAR is a safe and effective proximal repair intervention for cTBAD that can reliably induce the positive remodeling of the descending aorta.

Morphologic characteristics and endovascular management of acute type B dissection patients with superior mesenteric artery involvement.

OBJECTIVE: Despite its association with static mesenteric malperfusion, the morphologic characteristics and optimal management of acute type B aortic dissection (ABAD) with superior mesenteric artery (SMA) involvement are poorly understood. We studied the associated risk factors and reported the outcomes of endovascular treatment. METHODS: From May 2016 to May 2018, we examined 212 consecutive patients with ABAD in our center. Those with SMA involvement (SMAI) were included in the present study and divided into those with and without mesenteric malperfusion (MMP) according to the clinical findings. After thoracic endovascular aortic repair (TEVAR) with or without SMA revascularization, we compared the clinical data, imaging results, and outcomes for those with and without MMP. RESULTS: Computed tomography angiography confirmed 44 cases of SMAI: 12 (27.3%) with MMP and 32 (72.7%) without MMP. The patients with MMP had presented more frequently with lower extremity malperfusion (33.3% vs 3.1%; P = .023) than had those without MMP, with an odds ratio of 14.15 (P = .047). Multivariate analysis showed that patients with a low true lumen (TL)/false lumen (FL) diameter ratio of the SMA (TL/FL-SMA <1) had a greater risk of developing MMP than those with a high TL/FL-SMA ratio of >1 (odds ratio, 8.49; 95% confidence interval, 1.24-58.26; P = .029). SMA TL thrombosis was a significant predictor of the requirement for additional SMA revascularization after TEVAR among patients with MMP (P = .045). During a mean 10-month follow-up period, complete FL thrombosis in the SMA was seen in 11 patients (25%; 33.3% with MMP vs 21.9% without MMP; P = .43). The overall mortality rate was 6.82% (16.7% in the MMP group and 3.1% in the non-MMP group; P = .09). CONCLUSIONS: In the present study, limb ischemia and the TL/FL-SMA ratio were two independent predictors for the development of MMP in patients with ABAD and SMAI. We found that TEVAR can be safely performed for these patients, and SMA TL thrombosis predicted for the need for SMA revascularization.

A new hand-held holder optimizes the parameters of the laser-induced choroidal neovascularization model in mice.

BACKGROUND: The laser-induced choroidal neovascularization (CNV) mouse model, as the most classic animal model of age-related macular degeneration (AMD), has been widely used. We designed a hand-held mouse holder to optimize mouse fixation in the laser-induced CNV modelling process, which was inconvenient until now. This study aimed to evaluate the effectiveness of our in-house hand-held mouse holder design in the laser-induced CNV mouse modelling process. METHODS: Six ophthalmic residents were invited to perform laser-induced CNV mouse modelling by hand or using the holder. We compared the learning time of residents and their physical and mental fatigue with the two methods. In addition, we compared the parameters of CNV modelling with two methods by a skilled operator, including the time of photocoagulation, induction rate and uniformity of CNV lesions. RESULTS: In the learning phase, the average learning time to master the modelling method was significantly shortened by utilizing the holder. The fatigue in the operation process was quantified to a level from 0 to 4, and the physical fatigue by using holder (0.8 ± 0.3) was lower than by hand (2.6 ± 0.4), and the mental fatigue was relieved from 2.3 ± 0.5 to 0.4 ± 0.3. On the other hand, the skilled operator can significantly shorten the time of laser photocoagulation from 146.7 ± 36.0 s to 63.6 + 5.7 s and improve the success rate of modelling from 50.0% ± 8.3%-87.5% ± 6.7% by using a holder compared to hand. In addition, the standard error of the mean (SEM) of the distance between the CNV lesion and the optic nerve (ON) and the distance between each lesion was reduced. CONCLUSION: This hand-held mouse holder could optimize the setting and conditions of laser-induced CNV mouse modelling by improving the learning curve, reducing fatigue, shortening the time for photocoagulation, improving the success rate and consistency of laser-induced lesions.

Engineering of nanomaterials for mass spectrometry analysis of biomolecules.

Mass spectrometry (MS) based analysis has received intense attention in diverse biological fields. However, direct MS interrogation of target biomolecules in complex biological samples is still challenging, due to the extremely low abundance and poor ionization potency of target biological species. Innovations in nanomaterials create new auxiliary tools for deep and comprehensive MS characterization of biomolecules. More recently, growing research interest has been directed to the compositional and structural engineering of nanomaterials for enriching target biomolecules prior to MS analysis, enhancing the ionization efficiency in MS detection and designing biosensing nanoprobes in sensitive MS readout. In this review, we mainly focus on the recent advances in the engineering of nanomaterials towards their applications in sample pre-treatment, desorption/ionization matrices and ion signal amplification for MS profiling of biomolecules. This review will provide a toolbox of nanomaterials for researchers devoted to developing analytical methods and practical applications in the biological MS field.

Efficacy and Safety of a Novel Helical Self-Expanding Nitinol Stent for Femoropopliteal Artery Obliterans Disease.

BACKGROUND: The aim of this study was to evaluate the efficacy and safety of a novel self-expanding nitinol stent (Smartflex stent) in femoropopliteal artery obliterans disease. METHODS: From June 2016 to May 2019, patients with atherosclerotic occlusion disease of the superficial femoral and popliteal arteries using the Smartflex stents were retrospectively analyzed in our institution. Patients were monitored at 1, 3, 6, and 12 months and annually thereafter. The main characteristics of the diseased vessels, perioperative and follow-up outcome were evaluated. Kaplan-Meier method was used to assess patency rate and the rate of freedom from clinically driven target lesion revascularization (CD-TLR). RESULTS: A total of 50 limbs from 48 patients (mean age 69.4 ± 8.95 years; 38 men) were included. Eighty-eight Smartflex stents (1.76 stents per limb) were deployed successfully. Of the study patients, 82% had claudication (Rutherford III), 10% had rest pain (Rutherford IV), and 8% had tissue loss (Rutherford V). Trans-Atlantic Inter-Society Consensus II C and D lesions were 26% and 42%, respectively. The mean lesion length was 18.2 ± 8.5 cm and the mean stented length was 22.3 ± 9.9 cm. The average follow-up time was 16.4 ± 8.2 months. Of these lesions, 42 (94%) were chronic total occlusions and 16 (32%) were severely calcified. The primary patency rate at 1 year per Kaplan-Meier estimating, the rate of freedom from CD-TLR at 1 year, and the second patency rate was 83.3%, 88.1%, and 94%, respectively. Among them, 90% patients had improved ankle-brachial indexes (0.47 ± 0.13 before and 0.84 ± 0.16 after). No stent fractures and kinking were identified. CONCLUSIONS: Stenting of the femoropopliteal artery diseases using the Smartflex stent appeared to be safe and effective. It performed well in long-segment and above knee joint lesions.

Gastrointestinal failure score in children with traumatic brain injury.

BACKGROUND: To review the value of the gastrointestinal failure (GIF) score in children with different degrees of traumatic brain injury (TBI) by analyzing the correlation between outcome and gastrointestinal function. METHODS: A total of 165 children with TBI who were diagnosed and treated in the surgical intensive care unit (SICU) for longer than 72 h between August 2017 and September 2019 were analyzed. Admission parameters included sex, age, Glasgow Coma Scale (GCS) score, body mass index (BMI), leukocyte count, C-reactive protein (CRP), hemoglobin (Hb), hematocrit (Hct), blood glucose, lactic acid, procalcitonin (PCT), albumin, plasma osmotic pressure, prothrombin time (PT) and activated partial thromboplastin time (APTT). To predict outcomes, the Pediatric Sequential Organ Failure Assessment (SOFA) score, Pediatric Clinical Illness Score (PCIS), and mean GIF score for the first three days were combined. RESULTS: The percentage of patients with gastrointestinal dysfunction on the first day was 78.8 %. Food intolerance (FI) and intra-abdominal hypertension (IAH) developed in 36.4 and 21.8 % of the patients, respectively. The GIF score and mean GIF score for the first three days were significantly different between children with different degrees of TBI (P < 0.05); these scores were also significantly different between patients who died and those who survived (P < 0.05). The mean GIF score for the first three days was identified as an independent risk factor for mortality (odds ratio > 1, 95 % confidence interval = 1.457 to 16.016, P < 0.01), as was the PCIS. Receiver operating characteristic (ROC) curve analysis suggested that the mean GIF score for the first three days had the same calibrating power as the PCIS in discriminating the risk of death of children. CONCLUSIONS: The incidence of gastrointestinal dysfunction in children with TBI is high. The GIF score has the ability to reflect the status of the gastrointestinal system. The mean GIF score for the first three days has high prognostic value for ICU mortality in the SICU.

Incentivizing for Truth Discovery in Edge-assisted Large-scale Mobile Crowdsensing.

The recent development of human-carried mobile devices has promoted the great development of mobile crowdsensing systems. Most existing mobile crowdsensing systems depend on the crowdsensing service of the deep cloud. With the increasing scale and complexity, there is a tendency to enhance mobile crowdsensing with the edge computing paradigm to reduce latency and computational complexity, and improve the expandability and security. In this paper, we propose an integrated solution to stimulate the strategic users to contribute more for truth discovery in the edge-assisted mobile crowdsensing. We design an incentive mechanism consisting of truth discovery stage and budget feasible reverse auction stage. In truth discovery stage, we estimate the truth for each task in both deep cloud and edge cloud. In budget feasible reverse auction stage, we design a greedy algorithm to select the winners to maximize the quality function under the budget constraint. Through extensive simulations, we demonstrate that the proposed mechanism is computationally efficient, individually rational, truthful, budget feasible and constant approximate. Moreover, the proposed mechanism shows great superiority in terms of estimation precision and expandability.

Long noncoding RNA GACAT3 promotes glioma progression by sponging miR-135a.

The long noncoding RNA (lncRNA) gastric cancer associated transcript 3 (GACAT3) has been reported to play important roles in human tumorigenesis. However, its expression pattern, functions, and underlying mechanism in glioma remain unclear. In the present study, we showed that GACAT3 is upregulated in glioma tissues and cell lines. Through online databases, luciferase reporter assays and RNA immunoprecipitation (RIP) assays, we determined that GACAT3 acts as a competing endogenous RNA (ceRNA) for microRNA (miR)-135a, which was downregulated and performed as a tumor inhibitor in glioma. Further, nicotinamide phosphoribosyl transferase (NAMPT) was confirmed as a target gene of miR-135a by a series of gain- and loss-of-function assays. Overall, the present study was the first to show that GACAT3 regulates the expression of NAMPT to promote glioma progression by sponging miR-135a. These findings provide a promising therapy strategy for glioma.

A novel endovascular occlusion device with a steerable introducer for embolization in a porcine model.

OBJECTIVES: It has been reported that vascular plugging has become a therapeutic alternative to coil embolization in certain cases that require occlusion. However, the use of a relatively large and rigid delivery sheath may be a limiting factor in vascular plug use. In this study, we aimed to determine the safety and efficacy of a novel transcatheter occlusion device with unique design and delivery system in a pig model. METHODS: The Cera vascular plug was delivered and deployed through the FuStar steerable introducer sheath, which can control tip direction during advancement. Twelve pigs were randomized to undergo an embolization procedure in which the Cera vascular plug was implanted into the left internal iliac artery (IIA) with the FuStar steerable introducer (n = 6) or a control introducer sheath. Another eight pigs were assigned to undergo an embolization procedure in which the test device was implanted into either the splenic artery (SA, n = 4) or the lower segmental branch of left renal artery (LRA, n = 4). Angiography and pathological examinations were performed to evaluate the outcomes. RESULTS: A total of 20 target vessels were embolized with a total of 22 test plugs. Compared with the control introducer, plug embolization through the FuStar steerable introducer was associated with shorter fluoroscopy time (21.50 ± 3.62 vs. 28.33 ± 2.16 min, P = 0.003) and less contrast medium (129.17 ± 22.68 vs. 162.50 ± 13.69 mL, P = 0.012). At the 2-month follow-up, angiography and pathological examinations did not show any evidence of migration, and persistent occlusion was observed in 18 of the 20 target vessels. Organ ischemia occurred when plugs were deployed within the lower segmental branch of the LRA. CONCLUSION: This novel device is suitable for therapeutic vascular embolization with the use of flexible delivery systems. The different outcomes of SA and LRA plugging suggested that the occluding device should be placed within the appropriate portion of the target vessel to allow the development of collateralization.

Television watching and risk of childhood obesity: a meta-analysis.

BACKGROUND: Over the last few decades, there has been a worldwide epidemic of childhood obesity. An important step in successful prevention in paediatrics is the identification of modifiable risk factors of childhood obesity. Many studies have evaluated the associations between television (TV) watching and childhood obesity but yielded inconsistent results. METHODS: To help elucidate the role of TV watching, PubMed and Embase databases were searched for published studies on associations between TV watching and childhood obesity. Random-effects models and dose-response meta-analyses were used to pool study results. RESULTS: Fourteen cross-sectional studies with 24 reports containing 106 169 subjects were included in the meta-analysis. Subgroup analyses were conducted by the available characteristics of studies and participants. The multivariable-adjusted overall OR of the childhood obesity for the highest vs. the lowest time of TV watching was 1.47 [95% confidence interval (95% CI): 1.33-1.62]. A linear dose-response relationship was also found for TV watching and childhood obesity (P < 0.001), and the risk increased by 13% for each 1 h/day increment in TV watching. Subgroup analysis showed a basically consistent result with the overall analysis. The association is observed in both boys and girls (for boys, OR 1.30, 95% CI 1.16-1.45; for girls, OR 1.26, 95% CI 1.11-1.41). CONCLUSIONS: our meta-analysis suggested that increased TV watching is associated with increased risk of childhood obesity. And restricting TV time and other sedentary behaviour of children may be an important public health strategy to prevent childhood obesity.

Personalized prediction of diabetic foot ulcer recurrence in elderly individuals using machine learning paradigms.

BACKGROUND: This study utilizes machine learning to analyze the recurrence risk of diabetic foot ulcers (DFUs) in elderly diabetic patients, aiming to enhance prevention and intervention efforts. OBJECTIVE: The goal is to construct accurate predictive models for assessing the recurrence risk of DFUs based on high-risk factors, such as age, blood sugar control, alcohol consumption, and smoking, in elderly diabetic patients. METHODS: Data from 138 elderly diabetic patients were collected, and after data cleaning, outlier screening, and feature integration, machine learning models were constructed. Support Vector Machine (SVM) was employed, achieving an accuracy rate of 93%. RESULTS: Experimental results demonstrate the effectiveness of SVM in predicting the recurrence risk of DFUs in elderly diabetic patients, providing clinicians with a more accurate tool for assessment. CONCLUSIONS: The study highlights the significance of machine learning in managing foot ulcers in elderly diabetic patients, particularly in predicting recurrence risk. This approach facilitates timely intervention, reducing the likelihood of patient recurrence, and introduces computer-assisted medical strategies in elderly diabetes management.

Morphological features and endovascular repair for type B multichanneled aortic dissection: A case report.

BACKGROUND: Among the various types of aortic dissection, multichanneled aortic dissection (MCAD) differs from classic double-channeled aortic dissection and involves the formation of an additional false lumen in the aortic wall or the flaps. It is considered a relatively rare condition with high perioperative mortality and morbidity. However, the morphological characteristic and the optimal therapeutic strategy for MCAD has not been fully determined. CASE SUMMARY: A 64-year-old man presented to our hospital with severe epigastric abdominal pain radiating to the back that was associated with nausea without emesis. A computed tomography angiogram was performed that revealed a type B aortic dissection with multiple channels extending from the level of the left subclavian artery to the bilateral femoral arteries. We used a medical three-dimensional modeling (3D) modeling system to identify the location and extension of multiple lumens from different angles. It also precisely located the two primary entries leading to the false lumens, which helped us to exclude the two false lumens with one stent-graft. CONCLUSION: By applying medical 3D modeling system, we discover the fragility of aortic wall and the collapse of true lumen caused by the multiple false lumens are the two morphological features of MCAD.

Ginsenoside Rb1 protects human vascular smooth muscle cells against resistin-induced oxidative stress and dysfunction.

Resistin has been shown to play a key role in inducing vascular smooth muscle cells (VSMCs) malfunction in the atherosclerosis progression. Ginsenoside Rb1 is the main component of ginseng, which has been used for thousands of years and has been reported to have a powerful vascular protective effect. The aim of this study was to explore the protective effect of Rb1 on VSMCs dysfunction induced by resistin. In the presence or absence of Rb1, human coronary artery smooth muscle cells (HCASMC) were treated at different time points with or without 40 ng/ml resistin and acetylated low-density lipoprotein (acetylated LDL). Cell migration and proliferation were analyzed using wound healing test and CellTiter Aqueous Cell Proliferation Assay (MTS) test, respectively. Intracellular reactive oxygen species (ROS) (H2DCFDA as a dye probe) and superoxide dismutase (SOD) activities were measured by a microplate reader and the differences between groups were compared. Rb1 significantly reduced resistin-induced HCASMC proliferation. Resistin increased HCASMC migration time-dependently. At 20 µM, Rb1 could significantly reduce HCASMC migration. Resistin and Act-LDL increased ROS production to a similar level in HCASMCs, while Rb1 pretreated group reversed the effects of resistin and acetyl-LDL. Besides, the mitochondrial SOD activity was significantly reduced by resistin but was restored when pretreated with Rb1. We confirmed the protection of Rb1 on HCASMC and suggested that the mechanisms involved might be related to the reduction of ROS generation and increased activity of SOD. Our study clarified the potential clinical applications of Rb1 in the control of resistin-related vascular injury and in the treatment of cardiovascular disease.

Progression of Thoracic Aortic Dissection Is Aggravated by the hsa_circ_0007386/miR-1271-5P/IGF1R/AKT Axis via Induction of Arterial Smooth Muscle Cell Apoptosis.

BACKGROUND: The molecular mechanisms associated with thoracic aortic dissection (TAD) remain poorly understood. A comprehensive high-throughput sequencing-based analysis of the circRNA-miRNA-mRNA competitive endogenous RNA (ceRNA) regulatory network in TAD has not been conducted. The purpose of this study is to identify and verify the key ceRNA networks which may have crucial biological functions in the pathogenesis of TAD. METHODS: Gene expression profiles of the GSE97745, GSE98770, and GSE52093 datasets were acquired from the Gene Expression Omnibus (GEO) database. Differentially expressed genes (DEGs) were identified using the GEO2R tools. Protein-protein interaction (PPI) networks of the hub genes were constructed using STRING; the hub genes and modules were identified by MCODE and CytoHubba plugins of the Cytoscape. We analyzed the hub genes using Gene Ontology and Kyoto Encyclopedia of Genes and Genomes pathway enrichment analysis. The functions of these hub genes were assessed using Cytoscape software. Our data-along with data from GSE97745, GSE98770, and GSE52093-were used to verify the findings. RESULTS: Upon combined biological prediction, a total of 11 ce-circRNAs, 11 ce-miRNAs, and 26 ce-mRNAs were screened to construct a circRNA-miRNA-mRNA ceRNA network. PPI network and module analysis identified four hub nodes, including IGF1R, JAK2, CSF1, and GAB1. Genes associated with the Ras and PI3K-Akt signaling pathways were clustered in the four hub node modules in TAD. The node degrees were most significant for IGF1R, which were also the most significant in the two modules (up module and hub module). IGF1R was selected as a key gene, and the hsa_circ_0007386/miR-1271-5P/IGF1R/AKT regulatory axis was established. The relative expression levels of the regulatory axis members were confirmed by RT-PCR in 12 samples, including TAD tissues and normal tissues. Downregulation of IGF1R expression in smooth muscle cells (SMCs) was found to induce apoptosis by regulating the AKT levels. In addition, IGF1R showed high diagnostic efficacy in both AD tissue and blood samples. CONCLUSIONS: The hsa_circ_0007386/miR-1271-5P/IGF1R/AKT axis may aggravate the progression of TAD by inducing VSMCs apoptosis. CeRNA networks could provide new insights into the underlying molecular mechanisms of TAD. In addition, IGF1R showed high diagnostic efficacy in both tissue and plasma samples in TAD, which can be considered as a diagnostic marker for TAD.

Effects of COL1A1 and SYTL2 on inflammatory cell infiltration and poor extracellular matrix remodeling of the vascular wall in thoracic aortic aneurysm.

BACKGROUND: Thoracic aortic aneurysm (TAA) is a fatal cardiovascular disease, the pathogenesis of which has not yet been clarified. This study aimed to identify and validate the diagnostic markers of TAA to provide a strong theoretical basis for developing new methods to prevent and treat this disease. METHODS: Gene expression profiles of the GSE9106, GSE26155, and GSE155468 datasets were acquired from the Gene Expression Omnibus (GEO) database. Differentially expressed genes (DEGs) were identified using the "limma" package in R. Least absolute shrinkage and selection operator (LASSO), support vector machine-recursive feature elimination (SVM-RFE), random forest, and binary logistic regression analyses were used to screen the diagnostic marker genes. Single-sample gene set enrichment analysis (ssGSEA) was used to estimate immune cell infiltration in TAA. RESULTS: A total of 16 DEGs were identified. The enrichment and functional correlation analyses showed that DEGs were mainly associated with inflammatory response pathways and collagen-related diseases. COL1A1 and SYTL2 were identified as diagnostic marker genes with a high diagnostic value for TAA. The expression of COL1A1 and SYTL2 was considerably higher in TAA vascular wall tissues than in the corresponding normal tissues, and there were significant differences in the infiltration of immune cells between TAA and normal vascular wall tissues. Additionally, COL1A1 and SYTL2 expression were associated with the infiltration of immune cells in the vascular wall tissue. Single-cell analysis showed that COL1A1 in TAA was mainly derived from fibroblasts and SYTL2 mainly from CD8+ T cells. In addition, single-cell analysis indicated that fibroblasts and CD8+ T cells in TAA were significantly higher than those in normal arterial wall tissue. CONCLUSIONS: COL1A1 and SYTL2 may serve as diagnostic marker genes for TAA. The upregulation of SYTL2 and COL1A1 may be involved in the inflammatory infiltration of the vessel wall and poor extracellular matrix remodeling, promoting the progression of TAA.

Acute necrotizing encephalopathy in children with COVID-19: a retrospective study of 12 cases.

Background: Acute necrotizing encephalopathy (ANE) is a devastating neurologic condition that can arise following a variety of systemic infections, including influenza and SARS-Cov-2. The clinical features of COVID-19-associated ANE in pediatric patients based on multi-case data have not yet been described and remain obscure. We reviewed 12 pediatric patients to better describe the clinical features of ANE with COVID-19. Methods: We retrospectively collected and summarized the clinical features of ANE in children with COVID-19. Clinical data were collected from 12 children, including their general status, clinical symptoms, laboratory tests, and neuroimaging features. Results: Among the subjects, 10 were over 5 years old and they accounted for 83.33%. A large percentage of those affected (66.67%) were females. The major manifestations included fever (100%), impaired consciousness (100%), and convulsions (75%). We determined that increased interleukin (IL)-6 and IL-10, and tumor necrosis factor-α and interferon gamma were not predictive of severe ANE and mortality in children with COVID-19 in this study. All children presented with abnormal neuroimaging with multiple and symmetrically distributed lesions, involving the thalamus, basal ganglia, cerebellum, and brain hemispheres. Eight of the 12 children died, resulting in a mortality rate of 66.67%, and 75% of these children were females. Importantly, we found the timely administration of mannitol after an acute onset of convulsions or disturbance of consciousness may be decreased the high mortality induced by ANE children with COVID-19. Conclusion: COVID-19 associated with ANE in children is characterized by sudden symptom onset, rapid disease progression, and high mortality.

[Detection of microvasculature in rat hind limb using synchrotron radiation].

OBJECTIVE: To detect deep-level microvascular structure in rat hind limb by synchrotron radiation and microangiographic technique. METHODS: Microangiography in vivo and ex vivo was performed by synchrotron radiation based absorption imaging and phase contrast imaging, with omnipaque and barium sulfate solution as contrast media, respectively, and synchrotron radiation-based micro-computed tomography (SRmCT) was also performed to reveal three-dimensional morphology of the blood vessel in rat hind limb. RESULTS: Using microangiographic technique in vivo and in vitro (with barium sulfate), blood vessels in the rat limb muscle could be visualized with high resolution, and the fourth branches of iliac artery in rat hind limb could be detected with the minimum visualized blood vessels about 40 µm and 9 µm in diameter, respectively. In addition, the vascular network could be defined and analyzed at the micrometer scale from the 3D renderings of limb vessel as shown by SRmCT. CONCLUSION: Synchrotron radiation-based microangiography and SRmCT thus provided a practical and effective means to observe the microvasculature of rat hindlimb, which might be useful in assessment of angiogenesis in lower limbs.

Insights into electrochemiluminescence dynamics by synchronizing real-time electrical, luminescence, and mass spectrometric measurements.

Electrochemiluminescence (ECL) comprises a sophisticated cascade of reactions. Despite advances in mechanistic studies by electrochemistry and spectroscopy, a lack of access to dynamic molecular information renders many plausible ECL pathways unclear or unproven. Here we describe the construction of a real-time ECL mass spectrometry (MS) platform (RT-Triplex) for synchronization of dynamic electrical, luminescent, and mass spectrometric outputs during ECL events. This platform allows immediate and continuous sampling of newly born species at the Pt wire electrode of a capillary electrochemical (EC) microreactor into MS, enabling characterization of short-lived intermediates and the multi-step EC processes. Two ECL pathways of luminol are validated by observing the key intermediates α-hydroxy hydroperoxide and diazaquinone and unraveling their correlation with applied voltage and ECL emission. Moreover, a "catalytic ECL route" of boron dipyrromethene (BODIPY) involving homogeneous oxidation of tri-n-propylamine with the BODIPY radical cation is proposed and verified.