A single center retrospective study: Comparison between centrifugal separation plasma exchange with ACD-A and membrane separation plasma exchange with heparin on acute liver failure and acute on chronic liver failure.

The purpose of this retrospective study is to compare the efficacy and safety of the centrifugal separation therapeutic plasma exchange (TPE) using citrate anticoagulant (cTPEc) with membrane separation TPE using heparin anticoagulant (mTPEh) in liver failure patients. The patients treated by cTPEc were defined as cTPEc group and those treated by mTPEh were defined as mTPEh group, respectively. Clinical characteristics were compared between the two groups. Survival analyses of two groups and subgroups classified by the model for end-stage liver disease (MELD) score were performed by Kaplan-Meier method and were compared by the log-rank test. In this study, there were 51 patients in cTPEc group and 18 patients in mTPEh group, respectively. The overall 28-day survival rate was 76% (39/51) in cTPEc group and 61% (11/18) in mTPEh group (P > .05). The 90-day survival rate was 69% (35/51) in cTPEc group and 50% (9/18) in mTPEh group (P > .05). MELD score = 30 was the best cut-off value to predict the prognosis of patients with liver failure treated with TPE, in mTPEh group as well as cTPEc group. The median of total calcium/ionized calcium ratio (2.84, range from 2.20 to 3.71) after cTPEc was significantly higher than the ratio (1.97, range from 1.73 to 3.19) before cTPEc (P < .001). However, there was no significant difference between the mean concentrations of total calcium before cTPEc and at 48 h after cTPEc. Our study concludes that there was no statistically significant difference in survival rate and complications between cTPEc and mTPEh groups. The liver failure patients tolerated cTPEc treatment via peripheral vascular access with the prognosis similar to mTPEh. The prognosis in patients with MELD score < 30 was better than in patients with MELD score ≥ 30 in both groups. In this study, the patients with acute liver failure (ALF) and acute on chronic liver failure (ACLF) treated with cTPEc tolerated the TPE frequency of every other day without significant clinical adverse event of hypocalcemia with similar outcomes to the mTPEh treatment. For liver failure patients treated with cTPEc, close clinical observation and monitoring ionized calcium are necessary to ensure the patients' safety.

Construction of an Integrated Device of a Self-Powered Biosensor and Matching Capacitor Based on Graphdiyne and Multiple Signal Amplification: Ultrasensitive Method for MicroRNA Detection.

The detection of microRNA (miRNA) in human serum has great significance for cancer prevention. Herein, a novel self-powered biosensing platform is developed, which effectively integrates an enzymatic biofuel cell (EBFC)-based self-powered biosensor with a matching capacitor for miRNA detection. A catalytic hairpin assembly and hybrid chain reaction are used to improve the analytical performance of EBFC. Furthermore, the matching capacitor is selected as an auxiliary signal amplifying device, and graphdiyne is applied as substrate material for EBFC. The results confirm that the developed method obviously increases the output current of EBFC, and the sensitivity can reach 2.75 µA/pM, which is 786% of pure EBFC. MiRNA can be detected in an expanded linear range of 0.1-100000 fM with a detection limit of 0.034 fM (S/N = 3). It can offer a selective and sensitive platform for nucleotide sequence detection with great potential in clinical diagnostics.

Reduced intensity of early intensification does not increase the risk of relapse in children with standard risk acute lymphoblastic leukemia - a multi-centric clinical study of GD-2008-ALL protocol.

BACKGROUND: The prognosis of childhood acute lymphoblastic leukemia (ALL) is optimistic with a 5-year event-free survival (EFS) rate of 70-85%. However, the major causes of mortality are chemotherapy toxicity, infection and relapse. The Guangdong (GD)-2008-ALL collaborative protocol was carried out to study the effect of reduced intensity on treatment related mortality (TRM) based on Berlin-Frankfurt-Münster (BFM) 2002 backbone treatment. The study was designed to elucidate whether the reduced intensity is effective and safe for children with ALL. METHODS: The clinical data were obtained from February 28, 2008 to June 30, 2016. A total of 1765 childhood ALL cases from 9 medical centers were collected and data were retrospectively analyzed. Patients were stratified into 3 groups according to bone marrow morphology, prednisone response, age, genotype, and karyotype information: standard risk (SR), intermediate risk (IR) and high risk (HR). For SR group, daunorubicin was decreased in induction IA while duration was reduced in Induction Ib (2 weeks in place of 4 weeks). Doses for CAM were same in all risk groups - SR patients received one CAM, others got two CAMs. RESULTS: The 5-year and 8-year overall survival (OS), event-free survival (EFS) and cumulative incidence of relapse (CIR) were 83.5±0.9% and 83.1±1.0%, 71.9±1.1% and 70.9±1.2%, and 19.5±1.0% and 20.5±1.1%, respectively. The 2-year treatment-related mortality (TRM) was 5.2±0.5%. The 5-year and 8-year OS were 90.7±1.4% and 89.6±1.6% in the SR group, while the 5-year and 8-year EFS were 81.5±1.8% and 80.0±2.0%. In the SR group, 74 (15.2%) patients measured minimal residual disease (MRD) on Day 15 and Day 33 of induction therapy. Among them, 7 patients (9.46%) were MRD positive (≥ 0.01%) on Day 33. The incidence of relapse in the MRD Day 33 positive group (n=7) was 28.6%, while in the MRD Day 33 negative group (n=67) was 7.5% (p=0.129). CONCLUSIONS: The results of GD-2008-ALL protocol are outstanding for reducing TRM in childhood ALL in China with excellent long term EFS. This protocol provided the evidence for further reducing intensity of induction therapy in the SR group according to the risk stratification. MRD levels on Day 15 and Day 33 are appropriate indexes for stratification.

Large-Scale and Flexible Optical Synapses for Neuromorphic Computing and Integrated Visible Information Sensing Memory Processing.

Optoelectronic synapses integrating synaptic and optical-sensing functions exhibit large advantages in neuromorphic computing for visual information processing and complex learning, recognition, and memory in an energy-efficient way. However, electric stimulation is still essential for existing optoelectronic synapses to realize bidirectional weight-updating, restricting the processing speed, bandwidth, and integration density of the devices. Herein, a two-terminal optical synapse based on a wafer-scale pyrenyl graphdiyne/graphene/PbS quantum dot heterostructure is proposed that can emulate both the excitatory and inhibitory synaptic behaviors in an optical pathway. The simple device architecture and low-dimensional features of the heterostructure endow the optical synapse with robust flexibility for wearable electronics. This optical synapse features a linear and symmetric conductance-update trajectory with numerous conductance states and low noise, which facilitates the demonstration of accurate and effective pattern recognition with a strong fault-tolerant capability even at bending states. A series of logic functions and associative learning capabilities have been demonstrated by the optical synapses in optical pathways, significantly enhancing the information processing capability for neuromorphic computing. Moreover, an integrated visible information sensing memory processing system based on the optical synapse array is constructed to perform real-time detection, in situ image memorization, and distinction tasks. This work is an important step toward the development of optogenetics-inspired neuromorphic computing and adaptive parallel processing networks for wearable electronics.

[Ultrasound measurement of the testis volume of 0－14 years old Chinese boys].

OBJECTIVE: To obtain the normative values of the testis volume of 0－14 years old Chinese boys by ultrasound measurement. METHODS: We collected the testicular ultrasound data on 1607 Chinese boys with normal testes between January 2016 and June 2019. The boys were aged 0－14 years and divided into 14 age groups, with at least 100 cases in each group. We compared the mean, standard deviation and median of the testis volume among different age groups. RESULTS: The testis grew slowly in volume before 8 years old (0.372－0.678 ml), faster after 9 years old (1.040－4.600 ml), (1.040 ± 0.970) ml at 9－10 years, (1.876 ± 1.631) ml at 10－11 years, (2.831 ± 2.155) ml at 11－12 years, (3.640 ± 2.376) ml at 12－13 years, and (4.600 ± 3.559) ml at 13－14 years, larger in the 0－1 than in the 1－2 years group (ï¼»0.403 ± 0.130ï¼½ vs ï¼»0.372 ± 0.110ï¼½ ml, P = 0.04), negatively correlated in age between the two groups. CONCLUSIONS: Ultrasonography is an effective method for the measurement of the testis volume, which can provide the normative values of the testis volume of the 0－14 years old Chinese boys and some evidence for clinical diagnosis and consultation.

[Serum adiponectin and free fatty acid profile in essential hypertensive patients with or without metabolic syndrome].

OBJECTIVE: To observe serum adiponectin, free fatty acid (FFA) profile and other glucose and lipid metabolic parameters in essential hypertensive patients with metabolic syndrome (HPMS) or without metabolic syndrome (HP). METHODS: The serum adiponectin was measured with the radioimmunoassay, FFA profile measured with the gas chromatography and mass spectrometer in 72 HPMS, 56 HP and 43 normal control subjects. RESULTS: Serum adiponectin were significantly lower in HPMS group than those in the HP and control group (P < 0.05 or P < 0.01). Serum total free fatty acid (TFA), unsaturated fatty acid (UFA, linoleic acid, oleic acid, arachidonic acid, docosahexaenoic acid, eicosatrienoic acid), polyunsaturated fatty acid (PUFA) and n6PUFA were significantly higher in HPMS group than those in the HP and control groups (P < 0.05 or P < 0.01). Adiponectin was negatively correlated with body mass index, waist circumferences, waist hip ratio, triglycerides (r = -0.222, -0.235, -0.179, -0.194, P < 0.01 or P < 0.05, respectively) and positively correlated with high-density lipoprotein cholesterol (r = 0.336, P < 0.01); TFA and PUFA were positively correlated with body mass index, waist circumferences, fasting blood glucose, mean arterial pressure (r = 0.241 and 0.280, 0.198 and 0.188, 0.226 and 0.298, 0.274 and 0.334, P < 0.01 or P < 0.05, respectively) in all subjects. CONCLUSION: Our data suggest that changes in serum adiponectin, FFA and n6PUFA might promote the development of metabolic syndrome in essential hypertensive patients.