Children with severe neurological symptoms associated with SARS-CoV-2 infection during Omicron pandemic in China.

BACKGROUND: To analyze the clinical characteristics and outcomes of children with severe neurological symptoms associated with the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection during the Omicron pandemic in China. METHODS: This study used a questionnaire to obtain data from pediatric intensive care unit (PICU) centers in seven tertiary hospitals in Northeast China from December 1, 2022, to January 31, 2023. RESULTS: A total of 255 patients were confirmed to have SARS-CoV-2 infection, and 45 patients (17.65 %) were included in this study. Of these, seven (15.6%) patients died, and the median time from admission to death was 35 h (IQR, 14-120 h). Twenty (52.6%) survivors experienced neurological sequelae. Patients with platelet counts lower than 100 × 109/L had a higher incidence of complications such as multiple organ dysfunction, mechanical ventilation rate, and mortality. Cranial magnetic resonance imaging (MRI) always reveals cerebral tissue edema, with some severe lesions forming a softening site. CONCLUSION: Children infected with SARS-CoV-2 often exhibit severe neurological symptoms, and in some cases, they may rapidly develop malignant cerebral edema or herniation, leading to a fatal outcome. An early decrease in platelet count may associated with an unfavorable prognosis. IMPACT: Since early December 2022, China has gradually adjusted its prevention and control policy of SARS-CoV-2; Omicron outbreaks have occurred in some areas for a relatively short period. Due to the differences in ethnicity, endemic strains and vaccination status, there was a little difference from what has been reported about children with SARS-CoV-2 infection with severe neurological symptoms in abroad. This is the first multicenter clinical study in children with nervous system involvement after acute SARS-CoV-2 infection in China, and helpful for pediatricians to have a more comprehensive understanding of the clinical symptoms and prognosis of such disease.

Influences of abdominal core strengthening on explosive strength in martial arts athletes / Influências do fortalecimento abdominal sobre a força explosiva nos atletas de artes marciais / Influencia del fortalecimiento abdominal en la fuerza explosiva de atletas de artes marciales

ABSTRACT Introduction: Martial arts demand a high-stability from their athletes, allied to a fast speed in complex movements. These characteristics have been shown to increase in other sports with the strengthening of the abdominal core of their athletes, and it is believed that martial arts practitioners could also benefit from this additional exercise. Objective: Explore the influences of abdominal core strengthening on explosive strength in martial arts athletes. Methods: Twenty martial arts athletes were selected and randomly divided between the experimental and control group. The experimental group did abdominal core strength training associated with traditional physical training, while the control group practiced only traditional physical training. After the experiment, new physical tests were performed, comparing the pre and post results regarding peak torque, explosive strength, and impact explosive strength of martial arts athletes. Results: The relative strike force of the straight fist in the experimental group increased from 25.75 to 31.89 after the experiment; the relative strike force to the lower limbs increased from 37.64 to 47.00 after the experiment (p<0.05). Conclusion: After the executed strength training, the athletes' extensor peak torque and impact explosive strength indexes were significantly enhanced, evidencing the improvement of the explosive strength of martial arts athletes. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.

RESUMO Introdução: As artes marciais exigem de seus atletas uma alta estabilidade aliada a rápida velocidade em complexos movimentos. Essas características mostraram elevarem-se em outros esportes com o fortalecimento do centro abdominal de seus atletas e acredita-se que os praticantes de artes marciais também poderiam beneficiarem-se desse exercício adicional. Objetivo: Explorar as influências do fortalecimento do centro abdominal sobre a força explosiva nos atletas de artes marciais. Métodos: Vinte atletas de artes marciais foram selecionados e divididos aleatoriamente entre grupo experimental e controle. O grupo experimental fez o treinamento da força do centro abdominal associado ao treinamento físico tradicional enquanto o grupo de controle praticou apenas o treinamento físico tradicional. Após o experimento, foram feitos novos testes físicos, comparando os resultados prévios e posteriores referentes ao torque de pico, força explosiva e força explosiva de impacto dos atletas de artes marciais. Resultados: A força de golpe relativa do punho reto no grupo experimental aumentou de 25,75 para 31,89 após o experimento; a força de golpe relativa aos membros inferiores aumentou de 37,64 para 47,00 após o experimento (p<0.05). Conclusão: Após o treinamento de fortalecimento executado, o torque de pico dos extensores e os índices da força explosiva de impacto dos atletas foram significativamente reforçados, evidenciando a melhora da força explosiva dos atletas de artes marciais. Nível de evidência II; Estudos terapêuticos - investigação dos resultados do tratamento.

Resumen Introducción: Las artes marciales exigen de sus atletas una gran estabilidad aliada a una rápida velocidad en movimientos complejos. Se ha demostrado que estas características aumentan en otros deportes con el fortalecimiento del núcleo abdominal de sus atletas y se cree que los practicantes de artes marciales también podrían beneficiarse de este ejercicio adicional. Objetivo: Explorar las influencias del fortalecimiento del núcleo abdominal sobre la fuerza explosiva en atletas de artes marciales. Métodos: Se seleccionaron veinte atletas de artes marciales y se dividieron aleatoriamente entre el grupo experimental y el de control. El grupo experimental realizó un entrenamiento de fuerza en el núcleo abdominal asociado al entrenamiento físico tradicional, mientras que el grupo de control sólo practicó el entrenamiento físico tradicional. Tras el experimento, se realizaron más pruebas físicas comparando los resultados previos y posteriores en relación con el par máximo, la fuerza explosiva y la fuerza explosiva de impacto de los atletas de artes marciales. Resultados: La fuerza relativa de golpeo del puño recto en el grupo experimental aumentó de 25,75 a 31,89 después del experimento; la fuerza relativa de golpeo del miembro inferior aumentó de 37,64 a 47,00 después del experimento (p<0,05). Conclusión: Tras el entrenamiento de fortalecimiento ejecutado, aumentaron significativamente el par máximo de los extensores y los índices de fuerza explosiva de impacto de los atletas, lo que evidencia la mejora de la fuerza explosiva de los atletas de artes marciales. Nivel de evidencia II; Estudios terapéuticos - investigación de los resultados del tratamiento.

HMGA1 stimulates MYH9-dependent ubiquitination of GSK-3ß via PI3K/Akt/c-Jun signaling to promote malignant progression and chemoresistance in gliomas.

Myosin heavy chain 9 (MYH9) plays an essential role in human diseases, including multiple cancers; however, little is known about its role in gliomas. In the present study, we revealed that HMGA1 and MYH9 were upregulated in gliomas and their expression correlated with WHO grade, and HMGA1 promoted the acquisition of malignant phenotypes and chemoresistance of glioma cells by regulating the expression of MYH9 through c-Jun-mediated transcription. Moreover, MYH9 interacted with GSK-3ß to inhibit the expression of GSK-3ß protein by promoting its ubiquitination; the downregulation of GSK-3ß subsequently promoted the nuclear translocation of ß-catenin, enhancing growth, invasion, migration, and temozolomide resistance in glioma cells. Expression levels of HMGA1 and MYH9 were significantly correlated with patient survival and should be considered as independent prognostic factors. Our findings provide new insights into the role of HMGA1 and MYH9 in gliomagenesis and suggest the potential application of HMGA1 and MYH9 in cancer therapy in the future.

Acupuncture for chronic hepatitis B.

BACKGROUND: Chronic hepatitis B is a liver disease associated with high morbidity and mortality. Chronic hepatitis B requires long-term management aiming to reduce the risks of hepatocellular inflammatory necrosis, liver fibrosis, decompensated liver cirrhosis, liver failure, and liver cancer, as well as to improve health-related quality of life. Acupuncture is being used to decrease discomfort and improve immune function in people with chronic hepatitis B. However, the benefits and harms of acupuncture still need to be established in a rigorous way. OBJECTIVES: To assess the benefits and harms of acupuncture versus no intervention or sham acupuncture in people with chronic hepatitis B. SEARCH METHODS: We undertook electronic searches of the Cochrane Hepato-Biliary Group Controlled Trials Register, CENTRAL, MEDLINE, Embase, LILACS, Science Citation Index Expanded, Conference Proceedings Citation Index - Science, China National Knowledge Infrastructure (CNKI), Chongqing VIP (CQVIP), Wanfang Data, and SinoMed to 1 March 2019. We also searched the World Health Organization International Clinical Trials Registry Platform (www.who.int/ictrp), ClinicalTrials.gov (www.clinicaltrials.gov/), and the Chinese Clinical Trial Registry (ChiCTR) for ongoing or unpublished trials until 1 March 2019. SELECTION CRITERIA: We included randomised clinical trials, irrespective of publication status, language, and blinding, comparing acupuncture versus no intervention or sham acupuncture in people with chronic hepatitis B. We included participants of any sex and age, diagnosed with chronic hepatitis B as defined by the trialists or according to guidelines. We allowed co-interventions when the co-interventions were administered equally to all intervention groups. DATA COLLECTION AND ANALYSIS: Review authors in pairs individually retrieved data from reports and through correspondence with investigators. Primary outcomes were all-cause mortality, proportion of participants with one or more serious adverse events, and health-related quality of life. Secondary outcomes were hepatitis B-related mortality, hepatitis B-related morbidity, and adverse events considered not to be serious. We presented the pooled results as risk ratios (RRs) with 95% confidence intervals (CIs). We assessed the risks of bias using risk of bias domains with predefined definitions. We put more weight on the estimate closest to zero effect when results with fixed-effect and random-effects models differed. We evaluated the certainty of evidence using GRADE. MAIN RESULTS: We included eight randomised clinical trials with 555 randomised participants. All included trials compared acupuncture versus no intervention. These trials assessed heterogeneous acupuncture interventions. All trials used heterogeneous co-interventions applied equally in the compared groups. Seven trials included participants with chronic hepatitis B, and one trial included participants with chronic hepatitis B with comorbid tuberculosis. All trials were assessed at overall high risk of bias, and the certainty of evidence for all outcomes was very low due to high risk of bias for each outcome, imprecision of results (the confidence intervals were wide), and publication bias (small sample size of the trials, and all trials were conducted in China). Additionally, 79 trials lacked the necessary methodological information to ensure their inclusion in our review.None of the included trials aim to assess all-cause mortality, serious adverse events, health-related quality of life, hepatitis B-related mortality, and hepatitis B-related morbidity. We are uncertain whether acupuncture, compared with no intervention, has an effect regarding adverse events considered not to be serious (RR 0.67, 95% CI 0.43 to 1.06; I² = 0%; 3 trials; 203 participants; very low-certainty evidence) or detectable hepatitis B e-antigen (HBeAg) (RR 0.64, 95% CI 0.11 to 3.68; I² = 98%; 2 trials; 158 participants; very low-certainty evidence). Acupuncture showed a reduction in detectable hepatitis B virus (HBV) DNA (a non-validated surrogate outcome; RR 0.45, 95% CI 0.27 to 0.74; 1 trial, 58 participants; very low-certainty evidence). We are uncertain whether acupuncture has an effect regarding the remaining separately reported adverse events considered not to be serious.Three of the eight included trials received academic funding from government or hospital. None of the remaining five trials reported information on funding. AUTHORS' CONCLUSIONS: The clinical effects of acupuncture for chronic hepatitis B remain unknown. The included trials lacked data on all-cause mortality, health-related quality of life, serious adverse events, hepatitis-B related mortality, and hepatitis-B related morbidity. The vast number of excluded trials lacked clear descriptions of their design and conduct. Whether acupuncture influences adverse events considered not to be serious is uncertain. It remains unclear if acupuncture affects HBeAg, and if it is associated with reduction in detectable HBV DNA. Based on available data from only one or two small trials on adverse events considered not to be serious and on the surrogate outcomes HBeAg and HBV DNA, the certainty of evidence is very low. In view of the wide usage of acupuncture, any conclusion that one might try to draw in the future should be based on data on patient and clinically relevant outcomes, assessed in large, high-quality randomised sham-controlled trials with homogeneous groups of participants and transparent funding.

[Progress in the physiological and pathophysiological functions of sodium calcium exchangers].

Sodium calcium exchanger (NCX), which is widely expressed in the plasma membrane, mitochondrial membrane and secretory vesicles in diverse kinds of cells, belongs to a type of cation translocators. NCX works in two modes, the forward mode and reverse mode, to regulate the intracellular Ca(2+) concentration bi-directionally. In the forward mode, NCX carries Ca(2+) out of the cell against its electrochemical gradients coupled to the influx of Na(+) down its electrochemical gradients; alternatively, Ca(2+) enters through the reverse mode of NCX, and Na(+) is carried out of the cell. Exactly through the two-way modes, NCX can regulate intracellular Ca(2+) concentration fleetly and accurately, and plays a critical role in a series of physiological processes including intracellular signal transduction, growth and development of cells, excitation and its coupled functions of excitable cells. NCX are acknowledged to be involved in myofiber contraction, neurotransmission, migration and differentiation of neurogliocyte, activation of immune cells, secretion of cytokines and hormones etc. Moreover, abnormal activation of the reverse mode of NCX plays a vital role in many pathological processes including cell apoptosis, ischemia-reperfusion injury, insulin secretion, tumor etc. Here we reviewed the research status about the NCX's participation in some physiological and pathophysiological processes, so as to provide comprehensive understanding about its functions.

Societal perception and support for methadone maintenance treatment in a Chinese province with high HIV prevalence.

Methadone maintenance treatment (MMT) was first piloted in April 2004 in Yunnan, China, to reduce HIV transmission. This study aimed to examine public support for MMT and was based on cross-sectional data collected in March-April 2006 on a random sample of 411 police staff, medical/health professionals, community members, and drug users. Multivariate logistic regressions were used to analyze the data. The support was the strongest amongst the police and medical professionals but the lowest in drug users. A considerable proportion of the respondents viewed MMT as contradictory to China's drug control policies and this factor was negatively associated with support for MMT. Dissemination of more accurate knowledge and the resolution of these conflicts are urgently needed to increase the public support for MMT.

Sialoadenitis progression in nonobese diabetic mice and its correlation with expression of apoptosis-associated proteins in salivary glands and serum IgG levels.

BACKGROUND: Sjögren syndrome (SS) is an autoimmune disorder characterized by chronic lymphocytic infiltration and decreased secretion in salivary glands. Apoptosis is one of the possible mechanisms involved in acinar epithelial destruction in SS. The role of apoptosis in the initiation and effect phase of sialoadenitis is still controversial. The aim of this study was to observe the roles of apoptosis-associated proteins and serum IgG levels in sialoadenitis progression in nonobese diabetic (NOD) mice. METHODS: 2-, 5-, 10-, 15-, 20-week female NOD and matched BALB/c control mice were selected. Saliva and tear flow rate were measured. Serum IgG level was tested by enzyme-linked immunosorbent assay (ELISA). Number of lymphocyte foci (NLF) in submandibular glands (SMGs) was counted under routine hematoxylin/eosin-stained sections. Expression of Fas, Bcl-2 and procaspase3 proteins as well as apoptotic cells in the SMGs were detected by immunohistochemical staining and by terminal deoxynucleotidyl transferase-mediated dUTP nick-end labeling (TUNEL) assay respectively. RESULTS: Decreased stimulated total flow rate (STFR) and lymphocyte foci in SMGs were first observed in the 10-week NOD group. STFR was negatively correlated with NLF (P < 0.05). Serum IgG in NOD mice was significantly higher than that of the control group (P < 0.05) and showed a positive correlation with NLF (P < 0.05). Fas expression in SMGs acinar cells in NOD mice increased with age and was significantly higher compared with that in the control group. Bcl-2 expression and procaspase3 expression in SMG acinar cells in each NOD group were lower compared with those of the age-matched control mice. CONCLUSION: Abnormal expression of Fas and Bcl-2 in the SMGs and higher level of serum IgG may contribute to the initiation of sialoadenitis and cause the glandular destruction in NOD mice.