[A multicenter study of neonatal stroke in Shenzhen, China]. / 深圳市新生儿脑卒中多中心现况调查.

OBJECTIVES: To investigate the incidence rate, clinical characteristics, and prognosis of neonatal stroke in Shenzhen, China. METHODS: Led by Shenzhen Children's Hospital, the Shenzhen Neonatal Data Collaboration Network organized 21 institutions to collect 36 cases of neonatal stroke from January 2020 to December 2022. The incidence, clinical characteristics, treatment, and prognosis of neonatal stroke in Shenzhen were analyzed. RESULTS: The incidence rate of neonatal stroke in 21 hospitals from 2020 to 2022 was 1/15 137, 1/6 060, and 1/7 704, respectively. Ischemic stroke accounted for 75% (27/36); boys accounted for 64% (23/36). Among the 36 neonates, 31 (86%) had disease onset within 3 days after birth, and 19 (53%) had convulsion as the initial presentation. Cerebral MRI showed that 22 neonates (61%) had left cerebral infarction and 13 (36%) had basal ganglia infarction. Magnetic resonance angiography was performed for 12 neonates, among whom 9 (75%) had involvement of the middle cerebral artery. Electroencephalography was performed for 29 neonates, with sharp waves in 21 neonates (72%) and seizures in 10 neonates (34%). Symptomatic/supportive treatment varied across different hospitals. Neonatal Behavioral Neurological Assessment was performed for 12 neonates (33%, 12/36), with a mean score of (32±4) points. The prognosis of 27 neonates was followed up to around 12 months of age, with 44% (12/27) of the neonates having a good prognosis. CONCLUSIONS: Ischemic stroke is the main type of neonatal stroke, often with convulsions as the initial presentation, involvement of the middle cerebral artery, sharp waves on electroencephalography, and a relatively low neurodevelopment score. Symptomatic/supportive treatment is the main treatment method, and some neonates tend to have a poor prognosis.

The development and deployment of a model for hospital-level COVID-19 associated patient demand intervals from consistent estimators (DICE).

Hospitals commonly project demand for their services by combining their historical share of regional demand with forecasts of total regional demand. Hospital-specific forecasts of demand that provide prediction intervals, rather than point estimates, may facilitate better managerial decisions, especially when demand overage and underage are associated with high, asymmetric costs. Regional point forecasts of patient demand are commonly available, e.g., for the number of people requiring hospitalization due to an epidemic such as COVID-19. However, even in this common setting, no probabilistic, consistent, computationally tractable forecast is available for the fraction of patients in a region that a particular institution should expect. We introduce such a forecast, DICE (Demand Intervals from Consistent Estimators). We describe its development and deployment at an academic medical center in California during the 'second wave' of COVID-19 in the Unite States. We show that DICE is consistent under mild assumptions and suitable for use with perfect, biased and unbiased regional forecasts. We evaluate its performance on empirical data from a large academic medical center as well as on synthetic data.

[Comparison of relevant indicators of coagulation and fibrinolysis in patients with varying severity of community-acquired pneumonia].

OBJECTIVE: To compare the relevant indicators of coagulation and fibrinolysis in patients with varying severity of community-acquired pneumonia (CAP). METHODS: A total of 107 CAP hospitalized patients at Department of Respiratory Medicine, Affiliated Hospital, Chengde Medical College from July 2013 to June 2014 were enrolled as pneumonia group while another 52 healthy outpatients served as control group. The levels of routine blood test, coagulation function, procalcitonin and C-reactive protein (CRP) were measured and compared among different groups. All hospitalized CAP patients were divided into low and high-risk groups according to pneumonia severity index (PSI). And all indicators were measured to examine the differences among different groups. RESULTS: The white blood cell count in pneumonia group was significantly higher than that in control group ((9.3 ± 5.1) vs (7.5 ± 2.9) × 10(9)/L, P < 0.05). The red blood cell count, hemoglobin and platelet count in pneumonia group were significantly lower than those in control group ((4.3 ± 0.6) vs (4.8 ± 0.5) × 10(12)/L, (131.1 ± 18.7) vs (144.9 ± 17.4) g/L, (199.3 ± 69.4) vs (237.9 ± 72.5) × 10(9)/L, all P < 0.05). The D-dimer, fibrinogen degradation products (FDPs), fibrinogen (FIB), activated partial thromboplastin time (APTT) and prothrombin time (PT) in pneumonia group were significantly higher than those in control group ((1.86 ± 1.28) vs (0.48 ± 0.38) mg/L, (6.42 ± 3.27) vs (2.17 ± 1.46) mg/L, (3.87 ± 1.17) vs (3.42 ± 0.96) g/L, (35.64 ± 8.34) vs (31.29 ± 11.19) s, (12.21 ± 1.40) vs (11.36 ± 2.19) s, all P < 0.05) while thromboplastin time (TT) was lower than that in control group ((13.43 ± 3.38) vs (16.16 ± 2.89) s, P < 0.05). The levels of D-dimer, FDPs, procalcitonin, CRP, APTT and PT in high-risk group were significantly higher than those in low-risk group ((2.94 ± 1.14) vs (1.16 ± 0.78) mg/L, (8.85 ± 2.82) vs (4.85 ± 2.49) mg/L, (1.72 ± 1.16) vs (0.40 ± 0.51) µg/L, (104.2 ± 61.9) vs (67.4 ± 59.5) mg/L, (38.80 ± 8.41) vs (33.60 ± 7.69) s, (12.64 ± 1.76) vs (11.94 ± 1.03) s, all P < 0.05) while platelet count and TT were lower than those in low-risk group ((172.8 ± 57.1) vs (216.5 ± 71.6) × 10(9)/L, (12.10 ± 2.66) vs (14.28 ± 3.53) s, all P < 0.05). The abnormal rates of procalcitonin, D-dimer and FDPs in high-risk group were significantly higher than those in low-risk group (100% (42/42) vs 86.2% (56/65), 95.2% (40/42) vs 75.4% (49/65), 95.2% (37/42) vs 44.6% (29/65), all P < 0.05). The plasma levels of D-dimer, FDPs, procalcitonin and CRP were well-correlated with index of pneumonia severity (r = 0.636, 0.608, 0.629, 0.250, all P < 0.05). And the plasma level of platelet was negatively correlated with index of pneumonia severity (r = -0.320, P < 0.01). CONCLUSIONS: The red blood cell, hemoglobin and platelets are lower in patients with pneumonia than those in normal subjects. And the patients with pneumonia have coagulation and fibrinolysis disorders. The plasma levels of D-dimer, FDPs, procalcitonin, CRP and platelets are well-correlated with severity of CAP.

Investigate the potential impact of Hemagglutinin from the H1N1 strain on severe pneumonia.

The most prevalent glycoprotein on the influenza virus envelope is called hemagglutinin (HA), yet little is known about its involvement in the pathophysiology and etiology of severe influenza pneumonia. Here, after stimulating human bronchial epithelial cells (16-HBE) and mice with HA of H1N1 for 12 h, we investigated the proliferation, migration, inflammatory cytokines expression, and apoptosis in 16-HBE and the pathological damage in mouse lung tissue. The expression of inflammatory cytokines plasminogen activator inhibitor 1(PAI-1), urokinase-type (uPA) and tissue-type (tPA) plasminogen activators, and apoptosis were all enhanced by HA, which also prevented the proliferation and migration of bronchial epithelial cells. HA enhanced up-regulated PAI-1, uPA, and tPA protein expression within mouse lung tissue and caused lung injury. In conclusion, HA alone, but not the whole H1N1 virus, induces lung tissue injury by inhibiting cell proliferation and migration, while promoting the expression of inflammatory cytokines and apoptosis.

Automatic diagnosis of pneumothorax with M-mode ultrasound images based on D-MPL.

PURPOSE: To address the difficulties of M-mode ultrasound images classification in pneumothorax diagnosis and the shortcomings of existing neural network algorithms in this field, we proposed an M-mode ultrasound images classification model based on Disturbed Meta-Pseudo-Labels (D-MPL). METHODS: An M-mode ultrasound image augmentation system was designed to make the model more robust and generalizable. In D-MPL, teacher-generated pseudo-labeling was first taught to students through a soft mask, and additional disturbance data were added to the teacher network. As the loss of the teacher network continues to decline, disturbance data were injected to improve the generalization of the model to cope with image differences across patients in clinical settings. RESULTS: We compared the proposed model with four commonly used models, including MPL, EfficientnetB2, Inception V3, and Resnet101, in order to confirm its efficacy. Our model has an average specificity of 98.28%, sensitivity of 98.22%, F1-score of 98.23%, and AUC of 98.10%, according to the experiment findings, and its comprehensive performance is better than the above four models. CONCLUSION: The results demonstrated our model's superiority over the competition and its greater. The model proposed in this study is expected to assist doctors in the diagnosis of pneumothorax as an auxiliary mean.

Role of miR-584-5p in Lipopolysaccharide-Stimulated Human Bronchial Epithelial Cell Inflammation and Apoptosis.

Acute lung injury (ALI)/acute respiratory distress syndrome is a common clinical syndrome characterized by respiratory failure. MicroRNAs (miRNAs) are closely related to ALI and acute respiratory distress syndrome. TargetScan software analysis showed that miR-584-5p can bind to the 3' noncoding region of TLR4, which is involved in the occurrence and development of ALI, thereby affecting the inflammatory pathway and inflammation development. Thus, we aimed to determine whether miR-584-5p affects ALI. Human bronchial epithelial (16-HBE) cells were transfected with miR-584-5p mimics or inhibitors and then stimulated with lipopolysaccharide (LPS).The cell viability, apoptosis, release of proinflammatory factors, mTOR, and NF-κB pathway protein expression were evaluated respectively. Mimic584 increased, whereas inhibitor584 decreased, LPS-stimulated inflammation. The protein expression of inflammatory factors was significantly increased in 16-HBE cells in the mimic584 + LPS group and decreased in the inhibitor584 + LPS group. Mimic584 activated mTOR and the NF-κB-related proteins P65 and p-p65, whereas inhibitor584 inactivated the proteins in 16-HBE cells. Overexpression of miR-584 significantly promoted apoptosis in LPS-stimulated 16-HBE cells. There were no differences in the proliferation and cell cycle of LPS-stimulated 16-HBE cells regardless of mimic584 or inhibitor584 transfection. Collectively, we demonstrated that inhibitor584 can alleviate ALI-induced expression of inflammatory factors via mTOR signaling and the NF-κB pathway. In conclusion, we found that inhibitor584 transfection could be a potential therapeutic strategy for ALI.

Detection of microaneurysms and hemorrhages based on improved Hessian matrix.

PURPOSE: Knowing the early lesion detection of fundus images is very important to prevent blindness, and accurate lesion segmentation can provide doctors with diagnostic evidence. This study proposes a method based on improved Hessian matrix eigenvalue analysis to detect microaneurysms and hemorrhages in the fundus images of diabetic patients. METHODS: A two-step method including identification of lesion candidate regions and classification of candidate regions is adopted. In the first step, the method of eigenvalue analysis based on the improved hessian matrix was applied to enhance the image preprocessed. A dual-threshold method was used for segmentation. Then, blood vessels were gradually removed to obtain the lesion candidate regions. In the second step, all candidates were classified into three categories: microaneurysms, hemorrhages and the others. RESULTS: The proposed method has achieved a better performance compared with the existing algorithms on accuracy rates. The classification accuracy rates of microaneurysms and hemorrhages obtained by using our method were 94.4% and 94.0%, respectively, while the classification accuracy rates obtained by using Frangi's filter based on the Hessian matrix to enhance the image were 90.9% and 92.1%. CONCLUSION: This study demonstrated a methodology for enhancing images by using eigenvalue analysis based on the improved Hessian matrix and segmentation by using double thresholds. The proposed method is beneficial to improve the detection accuracy of microaneurysms and hemorrhages in fundus images.

Combined CT score, blood mononuclear cell count, LDH, and plasma D-dimer for viral pneumonia diagnosis: a retrospective study.

OBJECTIVE: Due to a continued increase in viral pneumonia incidence and resulting high mortality, fast and accurate diagnosis is important for effective management. This investigation examined the significance of blood biomarkers and the CT score in the early diagnosis of viral pneumonia. METHODS: Patients who were hospitalized due to radiologically-confirmed pneumonia and underwent virus antigen rapid test were enrolled. Their clinical information was compared. Blood mononuclear cell count, LDH, and plasma D-dimer were obtained. To evaluate the utility of biomarker levels in differentiating viral pneumonia from other pneumonia, ROC curves were developed to analyze the AUC. The optimal cut-off thresholds, specificity, sensitivity, and predictive values were assessed using the Youden index. The added value of the multi-marker approach was delineated using IDI and Reclassification analyses using NRI; IDI and NRI values were examined with 95% CI. RESULTS: Overall, 1163 inpatients were recruited between January 2017 and January 2021. They were sub-divided into the viral pneumonia (n = 563) and non-viral pneumonia (n = 600) categories. We found that the CT score, blood mononuclear cell count, LDH, and plasma D-dimer were markedly elevated in viral pneumonia patients. At an LDH threshold of 693.595 U/L, an AUC of ROC was 0.805 in differentiating viral pneumonia. The combination of CT score and blood biomarkers had an ROC AUC value of 0.908. CONCLUSIONS: Combining elevated biomarkers with CT assessments outperformed the CT score alone in identifying viral pneumonia. It is crucial to better characterize the significance of biomarkers in combination with CT assessments in the diagnosis of viral pneumonia.

Application of weighted gene co-expression network analysis to identify the hub genes in H1N1.

OBJECTIVE: Identifying the disease-associated interactions between different genes helps us to find novel therapeutic targets and predictive biomarkers. METHODS: Gene expression data GSE82050 from H1N1 and control human samples were acquired from the NCBI GEO database. Highly co-expressed genes were grouped into modules. Through Person's correlation coefficient calculation between the module and clinical phenotype, notable modules were identified. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analyses were conducted, and the hub genes within the module of interest were identified. Also, gene expression data GSE27131 were acquired from the GEO database to verify differential key gene expression analysis. The CIBERSORT was used to evaluate the immune cells infiltration and the GSVA was performed to identify the differentially regulated pathways in H1N1. The receiver operating characteristic (ROC) curves were used to assess the diagnostic values of the hub genes. RESULT: The black module was shown to have the highest correlation with the clinical phenotype, mainly functioning in the signaling pathways such as the mitochondrial inner membrane, DNA conformation change, DNA repair, and cell cycle phase transition. Through analysis of the black module, we found 5 genes that were highly correlated with the H1N1 phenotype. The H1N1 project from GSE27131 confirmed an increased expression of these genes. CONCLUSION: By using the WGCNA we analyzed and predicted the key genes in H1N1. BRCA1, CDC20, MAD2L1, MCM2, and UBE2C were found to be the most relevant genes, which may be therapeutic targets and predictive biomarkers for H1N1 therapy.

HA of H1N1 enhanced the expression of ICAM-1 and IL-6 in HUVECs and pathological injury in the lungs in mice.

OBJECTIVE: Both COVID-19 and influenza are viral respiratory tract infections and the epidemics of viral respiratory tract infections remain highly prevalent with lethal consequences in susceptible individuals. Expression of ICAM-1 on vascular endothelium recruits leukocytes which initiates inflammation. IL-6 induces ICAM-1. Both ICAM-1 and IL-6 can be enhanced in influenza virus infection and COVID-19 patients. Besides initiation of virus entry host cells, whether HA alone, instead of whole virus, of influenza has the effects on expression of ICAM-1 and IL-6 in vascular endothelium with injury in the lungs, remains to be demonstrated. METHODS: RT-qPCR and Western blot as well as histopathologic examination were used to examine mRNA and protein of ICAM-1 and IL-6 as well as pathological injury in the lung tissues, respectively. RESULTS: After incubation of the Human Umbilical Vein Endothelial Cells (HUVECs) with HA of H1N1 for 24 h, the mRNA and protein of ICAM-1 and IL-6 in HUVECs were increased in group of 5 µg/ml concentration with statistical significance (p < 0.05). Pathological injury in lung tissues of the mice was shown 12 h after tail intravenous injection with 100 µl of HA (50 µg/ml and 100 µg/ml in normal saline), including widened alveolar spaces with angiotelectasis in alveolar wall, alveolar luminal and interstitial inflammatory infiltrates, alveolar luminal erythrocyte effusion. CONCLUSIONS: HA alone, instead of whole H1N1 virus, induced more expression of ICAM-1 and IL-6, two molecules involving in pathological and inflammatory responses, in HUVECs and pathological injury in lung tissues of the mice. This knowledge provides a new HA-targeted potential direction for prevention and treatment of disease related to H1N1 infection.

Template-free synthesis of ordered ZnO@ZnS core-shell arrays for high performance supercapacitors.

In this article, ordered ZnO@ZnS core-shell structures have been produced on a stainless mesh by a two-step approach without using a template. ZnO nanorods fabricated by a chemical vapor method are transferred into a 50 ml autoclave for a second stage ion-exchange reaction followed by heating at 120 °C for 4-16 h. The ZnO core is prepared as the conducting channel and ZnS as the active material. Such unique architecture exhibits remarkable electrochemical performance with high capacitance and desirable cycle life. When evaluating as the electrode for supercapacitors, the ZnO@ZnS core-shell structure delivers a high specific capacitance of 603.8 F g-1 at a current density of 2 A g-1, with 9.4% capacitance loss after cycling 3000 times. The fabrication strategy presented here is simple and cost-effective, which can open new avenues for large-scale applications of the novel materials in energy storage.

Effects of bisphenol A on antioxidant system in soybean seedling roots.

Bisphenol A (BPA), an emerging pollutant in the environment, has potential toxic effects on plants. The toxicity mechanism, however, remains largely unknown. The antioxidant system plays an important role in protecting plants against the damage of stress. The present study investigated the effects of BPA on the antioxidant system (superoxide dismutase [SOD], peroxidase [POD], catalase [CAT], ascorbic acid [AsA], proline, reduced glutathione [GSH]), reactive oxygen species (ROS; hydrogen peroxide [H2 O2 ], superoxide anion [O2 (-) ]) accumulation, and membrane lipid peroxidation (malondialdehyde [MDA], cell membrane permeability) in soybean seedling roots. The 1.5 mg L(-1) BPA exposure did not affect test indices in the roots. Exposure to 3.0 mg L(-1) , 6.0 mg L(-1) , 12.0 mg L(-1) , or 24.0 mg L(-1) BPA caused increases in SOD (except for 3.0 mg L(-1) BPA) and CAT activities, as well as in AsA, proline, and GSH (except for 3.0 mg L(-1) BPA) content, leading to increases in the H2 O2 and O2 (-) content and to membrane lipid peroxidation. Exposure to 48.0 mg L(-1) or 96.0 mg L(-1) BPA caused decreases in the CAT activity and AsA/GSH content, as well as increases in the SOD and POD activities and the proline content, leading to excess ROS accumulation (i.e., H2 O2 and O2 (-) ) and cell membrane damage. After withdrawal of BPA exposure, ROS accumulation and membrane lipid peroxidation were alleviated by regulating a special antioxidant enzyme or substance.

Adenovirus-mediated NDRG2 inhibits the proliferation of human renal cell carcinoma cell line OS-RC-2 in vitro.

The objective of the study is to investigate the inhibitory effects of adenovirus-mediated N-Myc downstream-regulated gene 2 (NDRG2) on the proliferation of human renal cell carcinoma cell line OS-RC-2 in vitro. NDRG2 was harvested by RT-PCR, confirmed by DNA sequencing, and then cloned into the eukaryotic expression vector pIRES2-EGFP, which encodes green fluorescent protein (GFP), to construct pIRES2-EGFP-NDRG2 plasmid. OS-RC-2 cells with NDRG2 negative expression were transfected with pIRES2-EGFP-NDRG2 plasmid. The growth of transfected OS-RC-2 cells was observed under the light and fluorescence microscopes. After colony-forming cell assays, cell proliferation detection, and MTT assays, the growth curves of cells in each group were plotted to investigate the inhibitory effects of adenovirus-mediated NDRG2 on the proliferation of OS-RC-2 cells. Cell cycle was determined by flow cytometry. Confocal laser scanning microscopy was applied to determine the specific location of NDRG2 protein in subcellular level. A eukaryotic expression vector pIRES2-EGFP-NDRG2 was successfully constructed. After NDRG2 transfection, the growth of OS-RC-2 cells was inhibited. Flow cytometry showed that cells were arrested in S phase but the peak of cell apoptosis was not present, and confocal laser scanning microscopy showed that NDRG2 protein was located in mitochondrion. In conclusion, NDRG2 can significantly inhibit the proliferation of OS-RC-2 cells in vitro and its protein is specifically expressed in the mitochondrion.

[Epidemiologic study on the relationship between smoking and sleep apnea/hypopnea syndrome].

OBJECTIVE: To investigate how smoking was affecting the prevalence of sleep apnea/ hypopnea syndrome (SAHS) among adults aged over 30 years in Chengde city of Hebei province. METHODS: 1168 subjects, over 30 years of age were derived from a random sample from a community-based population in Shuangqiao district of Chengde city. All subjects responded to a questionnaire at their own houses regarding their habits of snoring and smoking. 1168 subjects (95.2%) answered the questions satisfactorily. RESULTS: (1) Among the smoking groups, the prevalence of snoring was 69.09%, higher than that in the nonsmoking groups 45.07% (P = 0.000). (2) In males, the smoking group had a higher prevalence (69.72%) of snoring than in the nonsmoking group (60.80%, P = 0.033). (3) Females in the smoking group had a higher prevalence of snoring (61.80%) than in the nonsmoking group (39.70%, P = 0.011). (4) The prevalence of snoring in males (60.80%) was significantly higher than that in females (39.70%, P = 0.000). (5) The prevalence (69.72%) of snoring in smoking males was similar to that in smoking females (61.80%, P = 0.336). (6) Data from logistic regression analysis indicated that smoking was one of the factors affecting snoring. (7) According to the degree of snoring, 127 moderate and severe snorers were measured by portable PSG for a whole night and the prevalence of SAHS was estimated. According to the AHI > or = 5 and the ESS > or = 9 cutoff-points, the prevalence rates of SAHS in smoking groups were both significantly higher than that in nonsmoking groups (P < 0.001). CONCLUSION: Smoking and snoring among adults aged over 30 years had correlation in our city.