[Emphasizing the innovation of urological robotic-assisted surgical instruments and technology driven by new quality productivity forces].

New quality productivity force is an advanced form of productive force that is innovation-driven, characterized by high technology, high efficiency, and high quality. It aligns with the new development philosophy and represents an advanced state of productivity. Within the medical sphere, this concept is epitomized by the progressive evolution of surgical instruments and techniques. In recent years, the rapid development of new quality productivity forces in the medical field has generated significant anticipation for innovations in urological robotic surgery instruments and techniques. Advancements in domestically produced robotic surgery systems, remote robotic surgery, single-port robotic surgery, and pediatric-specific robotic surgery exemplify the critical application of new quality productivity forces in urology. The integration of artificial intelligence, haptic feedback technology, and sensory enhancement technologies has further enhanced the safety and precision of surgeries. Driven by these new quality productivity forces, the development of urological robotic surgery instruments and techniques has reached a new milestone, potentially setting a new gold standard for urological surgeries and providing patients with safer, more efficient, and personalized medical care. However, certain emerging technologies still face challenges in their application, necessitating further research and clinical validation.

Observation of Anisotropic Superfluid Density in an Artificial Crystal.

We experimentally and theoretically investigate the anisotropic speed of sound of an atomic superfluid (SF) Bose-Einstein condensate in a 1D optical lattice. Because the speed of sound derives from the SF density, this implies that the SF density is itself anisotropic. We find that the speed of sound is decreased by the optical lattice, and the SF density is concomitantly reduced. This reduction is accompanied by the appearance of a zero entropy normal fluid in the purely Bose condensed phase. The reduction in SF density-first predicted [A. J. Leggett, Phys. Rev. Lett. 25, 1543 (1970).PRLTAO0031-900710.1103/PhysRevLett.25.1543] in the context of supersolidity-results from the coexistence of superfluidity and density modulations, but is agnostic about the origin of the modulations. We additionally measure the moment of inertia of the system in a scissors mode experiment, demonstrating the existence of rotational flow. As such we shed light on some supersolid properties using imposed, rather than spontaneously formed, density order.

Prediction of high-grade soft-tissue sarcoma using a combined intratumoural and peritumoural MRI-based radiomics nomogram.

AIM: To develop an intratumoural and peritumoural magnetic resonance imaging (MRI)-based radiomics nomogram for predicting tumour grade to improve clinical treatment and long-term prognosis. MATERIALS AND METHODS: MRI (3 T) features and T2-weighted imaging with fat-saturation (T2WI-FS)-based radiomics features of 57 patients with soft-tissue sarcoma (STS) were analysed retrospectively. Tumour size, ratio of width and length, relative depth to the peripheral fascia, peritumoural oedema, heterogeneity on T2WI, necrosis signal, enhancement model, and peritumoural enhancement were obtained. Independent risk factors were screened to construct an MRI feature nomogram. Radiomics features were obtained from intratumoural and peritumoural images on T2WI-FS. The optimal radiomics model was selected by the four-step dimensionality reduction method of minimum and maximum normalisation, optimal feature selection, selection based on support vector machine with L1-norm regularisation model, and iterative feature selection. MRI features and optimal radiomics features were used to construct a radiomics nomogram. The MRI feature nomogram model, the radiomics model, and the radiomics nomogram model were assessed by receiver operating characteristic (ROC) curves and calibration curves of the training and validation sets. RESULTS: Heterogeneity on T2WI and peritumoural enhancement were independent risk factors for predicting high-grade STS. The areas under the curves of the training set and verification set of the three models were as follows: MRI feature nomogram, 0.86 and 0.83, respectively; intratumoural and peritumoural combined radiomics model, 0.99 and 0.86, respectively; and radiomics nomogram model, 0.98 and 0.96, respectively. CONCLUSION: The radiomics nomogram model based on MRI features and combined intratumoural and peritumoural radiomic features was best able to predict high-grade STS.

[Efficacy and safety of transcatheter aortic valve replacement in the treatment of severe aortic stenosis].

Objective: To investigate the efficacy and safety of transcatheter aortic valve replacement (TAVR) in the treatment of severe aortic stenosis. Methods: The clinical data of patients with severe aortic stenosis who underwent TAVR at the People's Hospital of Xinjiang Uygur Autonomous Region between September 2016 and September 2022 were retrospectively analyzed. Changes in aortic transvalvular pressure gradients, valve orifice area, and activity tolerance of patients before and after the surgery were compared. Moreover, postoperative complications and follow-up results from 30 days to 6 years after the surgery were recorded. Results: A total of 76 patients were included in the study (50 males and 26 females), with an average age of (71.3±7.6) years, including 16 rheumatic valvular diseases, 60 senile degenerative diseases, 46 bicuspid valves and 30 tricuspid valves. The success rate of the operation was 96.1% (73/76). Compared with that before the operation, the mean aortic transvalvular pressure gradients decreased [(8.5±2.8) mmHg vs (68.5±19.2) mmHg (1 mmHg=0.133 kPa),P<0.001], but the valve orifice area increased [(1.91±0.31) cm2 vs (0.65±0.21) cm2, P<0.001]. Likewise, six-minute walking test (6MWT) showed that walking distance was longer after the surgery [(430±13) m vs (201±28) m, P<0.001]. There were 1 case of retroperitoneal hematoma, 1 case of stricture balloon dilatation after femoral artery suture concomitant with postoperative puncture site infection, 1 case of femoral artery surgical incision, 2 cases of valve-in-valve (ViV) and 5 cases of perivalvular leakage (4 cases were mild and 1 case was moderate) after the surgery, respectively. Moreover, acute left main artery occlusion during operation occurred in 1 case, ventricular rupture during operation occurred in 1 case and the patient was transferred to valve replacement surgery and finally dead, delayed coronary artery occlusion and death happened in 1 case, and all of the above-mentioned 3 cases were due to surgical failure. Postoperative pacemaker implantation due to third-degree atrioventricular block was performed in 5 cases. There were 1 case of pulmonary embolism, 1 case of transient right limb disorder, 1 case of gastrointestinal bleeding and 1 case of urethral bleeding after the surgery, respectively. The patients were followed up for (1.0±0.1) years (30 days to 6 years), and the results showed that 2 cases died, including 1 case died suddenly at home (the cause of death was unknown) and 1 case died of acute heart failure 8 months after the surgery. Chronic heart failure occurred repeatedly in 6 cases. The quality of life of other patients improved significantly. Conclusion: TAVR is effective and safe for patients with severe aortic stenosis.

[Identification of core pathogenic genes and pathways in elderly osteoporosis based on bioinformatics analysis].

Objective: Using bioinformatics methods to analyze the core pathogenic genes and related pathways in elderly osteoporosis. Methods: From November 2020 and August 2021, eight elderly osteoporosis patients who received treatment and five healthy participants who underwent physical examinations in Beijing Jishuitan Hospital were selected as subjects. The expression level of RNA in the peripheral blood of eight elderly osteoporosis patients and five healthy participants was collected for high-throughput transcriptome sequencing and analysis. The gene ontology (GO) analysis Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis was performed for the differentially expressed genes (DEGs). The protein-protein interaction (PPI) network was constructed using the STRING website and Cytoscape software, and the most significant modules and hub genes were screened out. Results: Among the eight elderly osteoporosis patients, there were seven females and one male, with an average age of 72.4 years (SD=4.2). Among the five healthy participants, there were four females and one male, with an average age of 68.2 years (SD=5.7). A total of 1 635 DEGs (847 up-regulated and 788 down-regulated) were identified. GO analysis revealed that the molecular functions of DEGs were mainly enriched in structural constituents of the ribosome, protein dimerization activity, and cellular components were mainly enriched in the nucleosome, DNA packaging complex, cytosolic part, protein-DNA complex and the cytosolic ribosome. KEGG pathway analysis showed that DEGs were mainly enriched in systemic lupus erythematosus and ribosome. Gene UBA52, UBB, RPS27A, RPS15, RPS12, RPL13A, RPL23A, RPL10A, RPS25 and RPS6 were selected and seven of them could encode ribosome proteins. Conclusion: The pathogenesis of elderly osteoporosis may be associated with ribosome-related genes and pathways.

[Genomic structure of varicella-zoster virus and its vaccine application status].

With the determination of the whole genome sequence of varicella-zoster virus (VZV) virus, the successful breakthrough of infectious cloning technology of VZV, and the emergence of effective preventive vaccines, which have been proven to be effective and safe, varicella has become a disease preventable by specific immunity. This article will review the genomic structure, epidemiological characteristics, and research application progress of varicella vaccine and herpes zoster vaccine of varicella zoster virus to provide reference for primary prevention of the disease.

[Preliminary insights into the practice of hypoallergenic home visiting program].

Allergic diseases affect about 40% of the world's population. Environmental factors are important in the occurrence and development of allergic diseases. Dust mites are one of the most important allergens in the indoor environment. The World Health Organization proposes the "four-in-one, combination of prevention and treatment" treatment principle for allergic diseases, in which environmental control to avoid or reduce allergens is the first choice for treatment. Modern people spend much more time at home (including sleeping) than outdoors, and the control of the home environment is particularly critical. This practice introduces the hypoallergenic home visit program, which including home environment assessment, environmental and behavioral intervention guidance, and common household hypoallergenic supplies and service guidance for the patient's home environment. The real-time semi-quantitative testing of dust mite allergens, qualitative assessments of other indoor allergens, record of patients' household items and lifestyle, and precise, individualized patient prevention and control education will be conducted. The hypoallergenic home visit program improves the doctors' diagnosis and treatment data dimension, and becomes a patient management tool for doctors outside the hospital. It also helps patients continue to scientifically avoid allergens and irritants in the environment, effectively build a hypoallergenic home environment, reduce exposure to allergens in the home environment, and achieve the goal of combining the prevention and treatment of allergic diseases.

[Diagnosis and treatment procedures and health management for patients with hereditary angioedema].

As a recognized rare and highly fatal disease, hereditary angioedema (HAE) is difficult to diagnose and characterized by recurrent edema involving the head, limbs, genitals and larynx, etc. Diagnosis of HAE is not difficult. However, low incidence and lack of clinical characteristics lead to difficulty of doctors on timely diagnosis and correct intervention for HAE patients. Therefore, it is crucial to improve the awareness of this disease and prevent its recurrence. for HAE patients. In view of absent cognition of doctors and the general public on HAE, patients often suffer from sudden death or become disabled due to laryngeal edema which cannot be treated in time. Thus, based on the Internet mobile terminal platform, the team set up an all-day rapid emergency response system which is provided for HAE patients by setting up "one-click help". The aim is to offer optimization on overall management of HAE and designed the intelligent follow-up management to provide timely assistance and specialized suggestion for patients with acute attacks.

Chronic pancreatitis in a caerulein-induced mouse model is associated with an altered gut microbiome.

BACKGROUND: Chronic pancreatitis (CP) is an inflammatory disease of the pancreas with loss of exocrine/endocrine functions as well as development of fibrosis. Dysbiosis of gut microbiome has been shown to be involved in the pathogenesis of many disease processes. Therefore, we aim to investigate the alteration in gut microbiome associated with CP in caerulein-induced mouse model. METHODS: CP was induced in C57Bl/6 by using caerulein injections (50 µg/kg/h, i.p., x7, twice weekly for 10 weeks). Stool samples were collected either one week after end of injection (10-week CP) or 6 weeks (16-week CP). DNA was extracted from stool samples and V4 region of 16S rDNA was sequenced for microbiome analysis. RESULTS: CP was strongly associated with the alteration in the composition of the gut microbiome, evidenced by differences in α and ß diversity. When ß diversity was measured using both weighted and unweighted UniFrac distances, stool from control mice is significantly different from mice on 10-week or 16-week CP (q < 0.01). The α-diversity measured by Faith's phylogenetic diversity was lowest in stool from healthy control and highest in stool from mice with 16-week CP (p < 0.001). Bacteria taxa differentially enriched in CP samples were detected using linear discriminant analysis. Bacteria from genera Bifidobacterium, Akkermansia, and Desulfovibrio were enriched in samples from 10-week CP mice. Bacteria from genera Allobaculum, Prevotella, and Bacteroides were enriched in samples from 16-week CP mice. CONCLUSION: Together, these analyses reveal pronounced alteration in the gut microbiome composition, diversity, and function when mice develop CP.

Efficacy and safety of closed-loop insulin delivery versus sensor-augmented pump in the treatment of adults with type 1 diabetes: a systematic review and meta-analysis of randomized-controlled trials.

BACKGROUND: Controversy remains regarding whether closed-loop (CL) insulin delivery or insulin sensor-augmented pump (SAP) delivery is more efficient for clinical treatment. Therefore, we aimed to compare the efficacy and safety of CL insulin delivery systems versus insulin SAP delivery for adults with type 1 diabetes (T1D). METHODS: Embase, Ovid MEDLINE, PubMed, ScienceDirect, Scopus, the Cochrane Library, and other databases were searched for related articles, and we analyzed the average blood glucose (BG), time in range (TIR), and adverse effects (AEs) as primary endpoints to evaluate efficacy and safety. RESULTS: Of 1616 articles, 12 randomized-controlled trials (RCTs) were included in the final analysis. Regarding BG control efficacy, CL insulin delivery resulted better outcomes than SAP therapy with regard to the average BG value, which was detected and recorded by continuous glucose monitoring (mean difference [MD][mmol/L]:  - 0.25 95% confidence interval [CI]  - 0.42 to - 0.08, p = 0.003); TIR 3.9-10 mmol/L (MD [%]: 7.91 95% CI 4.45-11.37, p < 0.00001). Similar results were observed for the secondary outcomes including low blood glucose index (LBGI) (MD:  - 0.41 95% CI - 0.55 to - 0.26, p < 0.00001), high blood glucose index (HBGI) (MD:  - 2.56 95% CI - 3.38 to - 1.74, p < 0.00001), and standard deviation (SD) of glucose variability (MD [mmol/L]: -0.25 95% CI - 0.44 to - 0.06, p = 0.01). Furthermore, SAP therapy was associated with more adverse effects (risk ratio: 0.20 95% CI 0.07-0.52, p = 0.001) than CL insulin delivery, and one of the most common adverse effects was hypoglycemia. CONCLUSIONS: CL insulin delivery appears to be a better treatment method than SAP therapy for adults with T1D because of its increased BG control efficacy and decreased number of hypoglycemic events.

[Association study between the KCNE family gene polymorphisms of potassium channel gene and the susceptibility of atrial fibrillation].

Objective: To investigate the relationship between KCNE family gene polymorphisms of potassium channel gene and the susceptibility of atrial fibrillation (AF). Methods: In the case-control study, a total of 648 subjects were studied, of which 338 patients with atrial fibrillation were selected from the Department of Cardiovascular Medicine, Putuo Hospital Affiliated to Shanghai University of Traditional Chinese Medicine from January 2019 to December 2019, and 310 healthy people were selected from the physical examination population during the same period. DNA sequencing technology and polymerase chain reaction (PCR) were used to detect the genotype and allele frequency of rs1805127 of KCNE1, rs9984281 of KCNE2, rs9516, rs626930 of KCNE3 and rs12621643 of KCNE4. Results: The ages of subjects in atrial fibrillation group and control group were (69±13) and (73±8) years, respectively (P=0.077). Men subjects accounted for 57.70% (195 men) and 40.00% (124 men) in the two groups, respectively (P=0.092). The distribution frequencies of the allele C at rs1805127 of gene KCNE1, the allele A at rs9984281 of gene KCNE2 and the allele G at rs12621643 of gene KCNE4 were significantly different between groups (P<0.05). After adjustment for sex, smoking, hypertension, cardiac insufficiency and other factors, it was found that the increase in the frequency of the above three loci would increase the risk of atrial fibrillation (rs1805127 OR=7.064, 95%CI:1.559-31.997; rs9984281 OR=4.210, 95%CI:1.118-15.850; rs12621643 OR=2.679, 95%CI:1.025-6.998). Conclusion: The rs1805127 of KCNE1, the rs9984281 of KCNE2,the rs12621643 of KCNE4 were significantly associated with the susceptibility to atrial fibrillation.

[Characteristics of visual function in children with autism complicated with mental retardation].

Objective: To explore the characteristics of visual function and eye diseases in children with autism spectrum disorder (ASD) and mental retardation. Methods: It was a cross-sectional study. Two hundred and ninety-two cases (584 eyes) of children with ASD combined with mental retardation from 7 special education schools in Chaoyang District of Beijing, including 235 males (80.48%) and 57 females (19.52%); The age ranged from 2 to 18 years old. Subjective far and near vision, near stereoacuity, objective vision, diopter, anterior segment and fundus were examined. In addition, 300 students with normal intelligence level, aged 2 to 18 years, were included as controls. LogMAR was used to record vision examination. Subjective, objective vision and diopter were examined. Mann Whitney U test or Kruskal Wallis H test was used for the data of children with different genders, different age. Results: Among 584 eyes of children with ASD and mental retardation, 272 eyes (47.22%) were ametropia, 260 eyes (45.14%) were astigmatism, 29 eyes (5.03%) were hyperopia, 10 eyes (1.74%) were myopia, and 47 eyes (8.16%) were amblyopia risk factors. Among 292 children, there were 20 cases of strabismus (6.85%), 3 cases of color weakness (1.03%), and 4 cases of external eye abnormalities (1.37%). Two hundred and eleven children completed near stereopsis examination, of which 54 (25.59%) were within 100″ and 157 (74.41%) were within 200″ to 900″. Two hundred and seventy-two eyes with ametropia, 157 eyes (57.72%) needed correction but did not. The median and quartile of subjective and objective logMAR visual acuity were 0.22(0.10, 0.35), 0.10(0.00, 0.22), respectively; There were no significant differences in far visual acuity, near visual acuity, objective visual acuity, diopter, and near stereoacuity between different genders of ASD children with mild or moderate mental retardation (all P>0.05); There was a statistically significant difference in ASD children with mild mental retardation at different age rangs (H=21.453, P<0.001). There was a statistically significant difference in subjective tests such as far visual acuity and near visual acuity, for children with moderate mental retardation (Z=-3.508, -4.503; P<0.001). There was no statistically significant difference in objective visual acuity, diopter and near stereo acuity(all P>0.05). There are 300 healthy children as the control group, with LogMar's subjective far vision is 0.10(0.00, 0.22), and the objective vision is 0.00(0.00, 0.10), diopter 0.25 (-0.25, 0.50) D. Compared with healthy children, ASD children with mental retardation had a significant difference in subjective far vision and objective vision (Z=-8.527, -10.393; P<0.001). There was no significant difference in diopter (Z=-1.274, P=0.203). Conclusions: The subjective and objective visual acuity of children with ASD combined with mental retardation was lower than that of healthy children. The prevalence and uncorrected rate of refractive errors, strabismus, amblyopia and other eye diseases were significantly higher than those of healthy children. Their refractive errors were mainly astigmatism, and the rates of correction and treatment were low.

[Impact and mechanism of CHL1 in insulin resistant adipocytes and insulin resistant mouse model induced by high glucose and high fat].

Objective: To investigate the role and mechanism of cell adhesion molecule L1 like (CHL1) in insulin resistant adipocytes and insulin resistant mouse model induced by high glucose and high fat. Methods: The 3T3-L1 preadipocytes were randomly divided into control group (transfected with empty vector) and CHL1 overexpression group (transfected with CHL1 vector), cells were then induced to mature adipocytes by insulin, and insulin resistance was then induced by high sugar and high fat. The glucose content was measured to determine the glucose consumption of cells from the two groups. Protein expression levels of CHL1 and glucose transporter 4 (GLUT4), serine/threonine protein kinase (AKT) phosphorylation levels were detected by Western blot (WB), the mRNA expression levels of TNF-α and IL-6 were detected by real-time quantitative PCR (RT-qPCR). 24 C57BL/6 adult male mouse were randomly divided into conventional diet group (regular group), high-fat diet group (high-fat group), empty vector overexpression+high-fat group and CHL1 overexpression+high-fat group (n=6 each group). CHL1 overexpression was induced by tail vein injection of lentivirus. Four months later, mice were sacrificed, body weight was determined, and the epididymal white adipose tissue was collect. Hematoxylin-eosin staining (HE) was used to observe the pathology of mouse epididymal white adipose tissue, the expression of CHL1 was evaluated by immunohistochemical staining(IHC), RT-qPCR was used to detect the mRNA expression levels of CHL1, TNF-α and IL-6 in mouse epididymal white adipose tissue. Results: In vitro, glucose consumption was significantly higher in the CHL1 overexpression group than in the control group (P<0.05), and the protein expressions of CHL1 and GLUT4 were higher in the CHL1 overexpression group than those in the control group (P<0.01), and the mRNA expressions levels of TNF-α and IL-6 were lower in the CHL1 overexpression group than those in the control group (P<0.01). In vivo, the body weight and epididymal white adipose tissue of mouse were higher in the high-fat group and the empty vector overexpression+high-fat group than those in the conventional group (P<0.01), which were lower in the CHL1 overexpression+high fat group than in the empty vector overexpression+high fat group (P<0.01). HE results showed that the volume of epididymal white adipocytes was larger in the high-fat group and the overexpression control+high-fat group than that in the conventional group, which was smaller in the CHL1 overexpression+high fat group than in the empty vector overexpression+high fat group (P<0.01). The mRNA expression levels of IL-6 and TNF-α in epididymal white adipose tissue of mice were higher in the high-fat group and the empty vector overexpression+high-fat group than those in the conventional group (P<0.01), which were lower in the CHL1 overexpression+high fat group than in the empty vector overexpression+high fat group (P<0.05). IHC results showed that protein expression of CHL1 in epididymal white adipose tissue was lower in the high-fat group and the empty vector overexpression+high-fat group than in regular group, which was upregulated in the CHL1 overexpression+high fat group than in the empty vector overexpression+high-fat group (P<0.01). RT-qPCR results showed that mRNA expression of CHL1 in epididymal white adipose tissue was lower in the high-fat group and the empty vector overexpression+high-fat group than in regular group (P<0.01), which was higher in the CHL1 overexpression+high fat group than in the empty vector overexpression+high fat group (P<0.01). Conclusion: Overexpression of CHL1 can improve insulin resistance in adipocytes and mouse insulin resistance model induced by high glucose and high fat, and the beneficial effects might be mediated by the inhibition of AKT activation and the reduction of related inflammatory responses.

Value of intravoxel incoherent motion and diffusion kurtosis imaging in predicting peritumoural infiltration of soft-tissue sarcoma: a prospective study based on MRI-histopathology comparisons.

AIM: To investigate the performance of intravoxel incoherent motion (IVIM) and diffusion kurtosis imaging (DKI) in the identification of peritumoural infiltration of soft-tissue sarcoma (STS). MATERIALS AND METHODS: From July 2018 to January 2020, 34 STS patients who underwent 3-T magnetic resonance imaging (MRI), including IVIM and DKI, were reviewed. The standard apparent diffusion coefficient (ADC), true diffusion (D), pseudo-diffusion coefficient (D∗), perfusion fraction (f), mean kurtosis (MK), and mean diffusion (MD) of each lesion were analysed independently by two observers. An MRI-histopathology control method was used to ensure the correspondence of MRI sections with histopathological sections. Differences in STS with and without infiltration were evaluated. The area under the curve (AUC) was used to determine the best cut-off point for different parameters. Interobserver agreement was assessed using the intraclass correlation coefficient. RESULTS: Standard ADC, D, MK, and MD values reliably distinguished STS that had positive and negative infiltration. The MD value had the best diagnostic performance. Use of an MD cut-off value of 2.35 × 10-3 mm2/s to distinguish positive and negative infiltration had an AUC of 0.85, accuracy of 88.2%, sensitivity of 94.4%, and specificity of 81.3%. The two independent observers had nearly perfect agreement for all parameters. CONCLUSION: The standard ADC and D value of IVIM, and the MK and MD values of DKI reliably identify the presence of peritumoural infiltration of STS.

[Clinical features and prognosis analysis of myelin oligodendrocyte glycoprotein antibody-positive optic neuritis].

Objective: To investigate the clinical characteristics and prognosis of myelin oligodendrocyte glycoprotein (MOG) antibody-positive optic neuritis (ON). Methods: The data of 39 patients with MOG antibody-positive ON in the Department of Neurology of Beijing Tongren Hospital, Capital Medical University from January 1, 2017 to October 31, 2019 were retrospectively collected. There were 25 males and 14 females, aged from 15 to 80 (40±16) years. According to the recurrence, the patients were divided into two groups: the recurrence group (n=12) and the non-recurrence group (n=27). The clinical manifestations, relapse-related factors, magnetic resonance imaging (MRI) manifestations, treatment and prognosis of the two groups were analyzed. Results: A total of 63 eyes were involved, including 30 cases of optic perineuritis (OPN), accounting for 47.6% (30/63). The number of attacks ranged from 1 to 9, among which 12 patients had more than 2 attacks. There were 37 eyes [58.7% (37/63)] with severe visual loss (SVL) at the time of onset, and 7 eyes [11.1% (7/63)] with SVL at the final follow-up. Forty-eight eyes [76.2% (48/63)] had optic disc edema. Forty seven eyes [74.6% (47/63)] showed long-segment disease on optic nerve MRI. One case was complicated with aseptic meningitis and encephalitis. The recurrence group was younger than the non-recurrence group [(28.5±9.8) years vs (43.3±16.4) years, P=0.001]. There were no statistically significant differences between the two groups in gender, bilateral onset, initial visual acuity, final visual acuity, optic disc edema, head and spinal cord lesions, and immunosuppressant (all P>0.05). All patients were treated with methylprednisolone (MP) pulse therapy during the acute attack, and 16 of them were additively treated with immunosuppressive agents; the pain was alleviated or relieved significantly after the application of glucocorticoids. Conclusions: MOG antibody-positive ON often occurred in both eyes at the same time, often manifesting as OPN, often accompanied by optic disc edema, and SVL at the beginning of the disease, but most of the visual recovery was good, might be associated with meningitis and encephalitis. MRI of the optic nerve showed that the lesions often manifested as long-segment lesions. Glucocorticoids could alleviate pain and promote the recovery of visual function.

Method to retrieve aerosol extinction profiles and aerosol scattering phase functions with a modified CCD laser atmospheric detection system.

Vertical distributions of ambient aerosols and their corresponding optical properties are crucial to the assessment of aerosol radiative effects. Traditionally, ambient aerosol phase function is assumed as a constant of input parameter in the retrieval of the vertical distribution of aerosol optical characteristics from remote sensing measurements (e.g. lidar or camera-laser based instruments). In this work, sensitivity studies revealed that using constant aerosol phase function assumptions in the algorithm would cause large uncertainties. Therefore, an improved retrieval method was established to simultaneously measure ambient aerosol scattering phase functions and aerosol scattering function profiles with a modified charge-coupled device-laser aerosol detection system (CLADS), which are then combined to yield vertical profiles of aerosol extinction coefficients. This method was applied and evaluated in a comprehensive field campaign in the North China Plain during January 2016. The algorithm showed robust performance and was able to capture temporal variations in ambient aerosol scattering phase functions and aerosol scattering function profiles. Aerosol extinction coefficients derived with simultaneously measured aerosol phase functions agreed well with in-situ measurements, indicating that uncertainties in the retrieval of aerosol extinction vertical profiles have been significantly reduced by using the proposed method with the modified CLADS. The advantage of this modified CLADS is that it can accomplish these aerosol measurements independent of other supplementary instruments. Benefiting from its low cost and high spatial resolution (∼1 m on average) in the boundary layer, this measurement system can play an important role in the research of aerosol vertical distributions and its impacts on environmental and climatic studies.

Emergency management of 2019 novel coronavirus: implications for the dermatology department.

Since cases first emerged in December 2019, COVID-19 (a type of coronavirus) has rapidly become pandemic. This fast-tracked paper (published quickly) from China on COVID-19 is written by dermatologists at the epicentre of the outbreak in Wuhan. Dermatology clinic staff may be at risk because protective equipment is not routinely available, and skin lesions might possibly transmit the virus indirectly. These authors suggest preventive measures based on experience in this and previous coronavirus outbreaks. Online consultation for non-urgent patients reduces the numbers of patients attending clinics. Nurse-led triage, to identify patients with possible COVID-19, at the entrances of hospital and skin clinics directs patients with a cough or fever to a specific COVID-19 area and a dermatologist is consulted if the fever might be related to skin disease. Clinic staff wear N95 masks and observe hand hygiene during consultations. Patients are admitted to a ward only if routine blood tests and chest CT scans exclude COVID-19. Triage will not detect patients who are showing no symptoms but who are developing the disease, so the hospital should provide an on-call expert team to discuss inpatients suspected or diagnosed with COVID-19 and refer them to radiology, respiratory or intensive care colleagues as required. Confirmed cases are managed following local policies. Skin disorders in COVID-19 inpatients can usually be managed remotely using photographs, email and teleconferencing. If necessary a multidisciplinary team (a team of medical staff from different specialties) can meet in the clean area of the isolation ward. If the dermatologist must see the patient, all records should be provided in advance to minimise exposure time. With these precautions, as of 20th February 2020 no infected patients were detected in the Wuhan Dermatology Department. This is a summary of the study: Emergency management for preventing and controlling nosocomial infection of 2019 novel coronavirus: implications for the dermatology department.

The diagnostic accuracy of dermoscopy and reflectance confocal microscopy for amelanotic/hypomelanotic melanoma: a systematic review and meta-analysis.

BACKGROUND: Dermoscopy and reflectance confocal microscopy (RCM) are noninvasive techniques for the diagnosis of skin lesions. Their accuracy for amelanotic/hypomelanotic melanoma (AHM) has not been systematically studied. OBJECTIVES: We aimed to investigate systematically the accuracy of dermoscopy and RCM and to compare the accuracy between them for diagnosing AHM. METHODS: We searched the PubMed, Web of Science, Embase and Cochrane Library databases for eligible studies about dermoscopy, RCM and AHM from inception to 31 June 2019. The quality of the studies was assessed with the Quality Assessment of Diagnostic Accuracy Studies tool. The pooled results were calculated using a random effects model in Stata 14, Meta-DiSc, RevMan 5·3 and SAS 9·4. We also explored the sources of heterogeneity by sensitivity analysis. RESULTS: Seven studies with a total of 1111 lesions were included. The pooled sensitivity and specificity of dermoscopy for the diagnosis of AHM were 61% [95% confidence interval (CI) 0·37-0·81] and 90% (95% CI 0·74-0·97), respectively. The corresponding respective values of RCM for the diagnosis of AHM were 67% (95% CI 0·51-0·81) and 89% (95% CI 0·86-0·92). In three studies including the performance of both RCM and dermoscopy, the relative diagnostic odds ratio of RCM over dermoscopy was 4·69 (95% CI 0·81-27·3) (P = 0·068). CONCLUSIONS: Our study demonstrates that both dermoscopy and RCM offer good diagnostic accuracy with high specificity and moderate sensitivity in the diagnosis of AHM. RCM is more accurate than dermoscopy in diagnosing AHM but the comparison needs to be confirmed. What's already known about this topic? Amelanotic/hypomelanotic melanoma (AHM) is the most lethal skin cancer. The diagnosis of AHM is a great challenge because of its nonspecific clinical manifestation. Early diagnosis can improve the prognosis. Dermoscopy and reflectance confocal microscopy (RCM) have high diagnostic accuracy for pigmented melanoma. What does this study add? Both dermoscopy and RCM offer good diagnostic accuracy with high specificity and moderate sensitivity for AHM. RCM might be more accurate than dermoscopy for diagnosis of AHM. More research on the diagnostic accuracy of dermoscopy and RCM for AHM is required in support of these findings.

Bacillus Calmette-Guérin vaccination and clinical characteristics and outcomes of COVID-19 in Rhode Island, United States: a cohort study.

Coronavirus disease 2019 (COVID-19) has resulted in a global pandemic, and there is limited data on effective therapies. Bacillus Calmette-Guérin (BCG) vaccine, a live-attenuated strain derived from an isolate of Mycobacterium bovis and originally designed to prevent tuberculosis, has shown some efficacy against infection with unrelated pathogens. In this study, we reviewed 120 consecutive adult patients (≥18 years old) with COVID-19 at a major federally qualified health centre in Rhode Island, United States from 19 March to 29 April 2020. Median age was 39.5 years (interquartile range, 27.0-50.0), 30% were male and 87.5% were Latino/Hispanics. Eighty-two (68.3%) patients had BCG vaccination. Individuals with BCG vaccination were less likely to require hospital admission during the disease course (3.7% vs. 15.8%, P = 0.019). This association remained unchanged after adjusting for demographics and comorbidities (P = 0.017) using multivariate regression analysis. The finding from our study suggests the potential of BCG in preventing more severe COVID-19.

Correlation between the hemoporfin-mediated photodynamic treatment response and the dermoscopy vascular pattern in patients with a port-wine stain: a prospective study.

BACKGROUND: Vascular targeted photodynamic therapy (PDT) is a novel and promising therapy for the treatment of port-wine stains (PWS). There has been little prior exploration to our knowledge of how the dermatological vascular pattern may predict the response to PDT. OBJECTIVES: To analyse whether the vascular pattern classifications of PWS by dermoscopy can predict the efficacy of PDT. METHODS: This prospective cohort study included 163 patients with a clinical diagnosis of PWS who were treated twice with hemoporfin-mediated photodynamic therapy (HMME-PDT) at two-month intervals and followed up for 6 months. The vascular manifestations of dermoscopy with PWS were independently classified into 8 categories by 3 dermatologists. Images of the lesions were taken using VISIA, and the vascular patterns were imaged by dermoscopy by the same investigator. Images were captured before and after each treatment. The efficacy was evaluated with pre- and post-treatment VISIA images, and correlations between efficacy and vascular patterns were analysed by four dermatologists in a blinded and independent manner, between 10 January 2019 and 11 December 2019. RESULTS: In the dermoscopy images for the whole cohort, dotted and globular vessels (15.3%), short clubbed vessels (18.4%) and curved vessels (12.9%) were highly associated with cure and beneficial treatment effects. Pale halos surrounding brown dots (8.0%) and arborizing vessels (9.8%) were mainly correlated with skin lesion alleviation. Mixed vessels (12.9%), a grey-whitish veil (11.7%) and reticular patterns (11.0%) were mainly associated with no effect. The differences between each subgroup were statistically significant (P = 0.000). CONCLUSIONS: There is a clear correlation between the efficacy of PDT and the dermoscopy pattern in patients with PWS. Dermoscopy may therefore provide very useful clinical information prior to treatment in these cases. In addition, the vascular manifestations of PWS determined by dermoscopy help to predict response to PDT and manage patient expectations.