Highly Antibacterial and Antioxidative Carbon Nanodots/Silk Fibroin Films for Fruit Preservation.

The issues of fruit waste and safety resulting from rot have spurred a demand for improved packaging systems. Herein, we present highly antibacterial and antioxidative carbon nanodot/silk fibroin (CD/SF) films for fruit preservation. The films are composed of CDs and SF together with a small amount of glycerol via hydrogen bonding, exhibiting outstanding biosafety, transparency, and stretchability. The films effectively integrate key functionalities (atmosphere control, resistance to food-borne pathogens, and antioxidation properties) and can be manufactured in large sizes (about 20 × 30 cm), boasting a transmission rate of 13 183 cm3/m2·day for oxygen and 2860 g/m2·day for water vapor, favoring the preservation of fresh fruits. A convenient dip-coating method enables in situ fabrication of films with a thickness of approximately 14 µm directly on the fruits' surface providing comprehensive protection. Importantly, the films are washable and biodegradable. This work presents a promising technology to produce multifunctional and eco-friendly antibacterial packaging systems.

[Multisystem inflammatory syndrome in children in the context of coronavirus disease 2019 pandemic]. / æ–°åž‹å† çŠ¶ç— æ¯’æ„ŸæŸ“æµè¡ŒèƒŒæ™¯ä¸‹çš„å„¿ç«¥å¤šç³»ç»Ÿç‚Žç—‡ç»¼åˆå¾.

Multisystem inflammatory syndrome in children (MIS-C) is a complex syndrome characterized by multi-organ involvement that has emerged in the context of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreak. The clinical presentation of MIS-C is similar to Kawasaki disease but predominantly presents with fever and gastrointestinal symptoms, and severe cases can involve toxic shock and cardiac dysfunction. Epidemiological findings indicate that the majority of MIS-C patients test positive for SARS-CoV-2 antibodies. The pathogenesis and pathophysiology of MIS-C remain unclear, though immune dysregulation following SARS-CoV-2 infection is considered a major contributing factor. Current treatment approaches for MIS-C primarily involve intravenous immunoglobulin therapy and symptomatic supportive care. This review article provides a comprehensive overview of the definition, epidemiology, pathogenesis, clinical presentation, diagnosis, treatment, and prognosis of MIS-C.

[Research advances in genetic polymorphisms in Kawasaki disease]. / å·å´Žç— åŸºå› å¤šæ€æ€§çš„ç ”ç©¶è¿›å±•.

Kawasaki disease (KD) is a systemic inflammatory vascular disorder that predominantly affects children and is the leading cause of acquired heart disease in children. Although the etiology of this disease remains unclear, genome-wide association and genome-wide linkage studies have shown that some susceptible genes and chromosomal regions are associated with the development and progression of KD. With the advancement of high-throughput DNA sequencing techniques, more and more genomic information related to KD is being discovered. Understanding the genes involved in the pathogenesis of KD may provide novel insights into the diagnosis and treatment of KD. By analyzing related articles and summarizing related research advances, this article mainly discusses the T cell activation-enhancing genes that have been confirmed to be closely associated with the development and progression of KD and reveals their association with the pathogenesis of KD and coronary artery lesions.

[Diagnosis and treatment of incomplete Kawasaki disease in children]. / å„¿ç«¥ä¸å®Œå ¨æ€§å·å´Žç— çš„è¯Šæ²».

Kawasaki disease (KD) is a febrile disease mainly observed in children aged <5 years, with medium- and small-vessel vasculitis as the main lesion. Although KD has been reported for more than 50 years and great progress has been made in the etiology and pathology of KD in recent years, there is still a lack of specific indicators for the early diagnosis of KD, especially with more difficulties in the diagnosis of incomplete Kawasaki disease (IKD). At present, there are no clear diagnostic criteria for IKD, which leads to the failure of the timely identification and standardized treatment of IKD in clinical practice and even induce the development of coronary artery lesion. This article reviews the concept, epidemiological features, diagnosis, treatment, and follow-up management of IKD, in order to deepen the understanding of IKD among clinical workers and help to improve the clinical diagnosis and treatment of KD in China.

Transthoracic, thoracoabdominal, and transabdominal surgical approaches for gastric cardia adenocarcinomas: a survival evaluation based on a cohort of 7103 patients.

BACKGROUND: This study compared the survival outcomes of different surgical approaches to determine the optimal approach for gastric cardia adenocarcinoma (GCA) and aimed to standardize the surgical treatment guidelines for GCA. METHODS: A total of 7103 patients with GCA were enrolled from our previously established gastric cardia and esophageal carcinoma databases. In our database, when the epicenter of the tumor was at or within 2 cm distally from the esophagogastric junction, the adenocarcinoma was considered to originate from the cardia and was considered a Siewert type 2 cancer. The main criteria for the enrolled patients included treatment with radical surgery, no radio- or chemotherapy before the operation, and detailed clinicopathological information. Follow-up was mainly performed by telephone or through home interviews. According to the medical records, the surgical approaches included transthoracic, thoracoabdominal, and transabdominal approaches. Kaplan-Meier and Cox proportional hazards regression models were applied to correlate the surgical approach with survival in patients with GCA. RESULTS: There were marked differences in age and tumor stage among the patients who underwent the three surgical approaches (P < 0.001). Univariate analysis showed that survival was related to sex, age, tumor stage, and N stage (P < 0.001 for all). Cox regression model analysis revealed that thoracoabdominal approach (P < 0.001) and transabdominal approach (P < 0.001) were significant risk factors for poor survival. GCA patients treated with the transthoracic approach had the best survival (5-year survival rate of 53.7%), and survival varied among the different surgical approaches for different tumor stages. CONCLUSION: Thoracoabdominal approach and transabdominal approach were shown to be poor prognostic factors. Patients with (locally advanced) GCA may benefit from the transthoracic approach. Further prospective randomized clinical trials are necessary.

Caulophyine A, a Rare Azapyrene Alkaloid from the Roots of Caulophyllum robustum.

A novel alkaloid caulophyine A (1) was isolated from the roots of Caulophyllum robustum Maxim., along with six known alkaloids 2-7. The structure of 1 was elucidated by extensive NMR and high resolution-time-of-flight (HR-TOF)-MS analyses, it is a rare nitrogen containing polycyclic aromatic hydrocarbon. The in vitro bioassays revealed that 2 presented remarkable cytotoxicity against A549 with an IC50 value of 3.83 µM in comparison with the positive control etoposide (IC50 = 11.63 µM). Compounds 1 and 2 also displayed weak Acetylcholinesterase (AChE) inhibitory activity with IC50 values of 123.03 and 80.74 µM respectively.

[Strengthening the prevention and treatment of Omicron infection in children]. / åŠ å¼ºå„¿ç«¥å¥¥å¯†å ‹æˆŽæ„ŸæŸ“çš„é˜²æ²».

Omicron is a newly discovered variant virus of coronavirus disease 2019 and has spread rapidly around the world. Omicron has been defined as a variant of concern by the World Health Organization. Its epidemiology, pathogenic characteristics, clinical diagnosis, treatment, and prevention are still being observed and summarized, and in particular, there are few reports on the diagnosis and treatment of children with Omicron infection. This article introduces the influence of Omicron infection in children and its prevention, diagnosis, and treatment.

[Clinical details in the diagnosis of Kawasaki disease]. / å·å´Žç— è¯Šæ–­è¿‡ç¨‹ä¸­éœ€è¦æ³¨æ„çš„ä¸´åºŠç»†èŠ‚.

Kawasaki disease (KD) is one of the leading causes of acquired heart diseases in children aged under 5 years. The clinical manifestations of KD include fever, changes in the extremities, rash or redness at the site of bacille Calmette-Guérin vaccination, bilateral bulbar conjunctival hyperemia, changes in lips and mouth, nonsuppurative cervical lymphadenopathy, and other systemic manifestations. There are difficulties in the diagnosis of KD due to its asynchronous clinical manifestations. With reference to the latest case reports and research advances in KD, this article summarizes the clinical details in the diagnosis of KD, so as to improve the level of clinical diagnosis of KD.

[Clinical experience in the treatment of incomplete Kawasaki disease with no response to intravenous immunoglobulin: a case report]. / é™è„‰æ³¨å°„å ç–«çƒè›‹ç™½æ— åº”ç­”ä¸å®Œå ¨æ€§å·å´Žç— 1例临床经验交流.

This article reports a case of incomplete Kawasaki disease with no response to intravenous immunoglobulin (IVIG). A girl, aged 1 year, had the symptoms of fever, rash, finger desquamation, and coronary artery ectasia. She still had fever at 36 hours after the first dose of IVIG treatment, and her temperature returned to normal after the second dose of IVIG treatment. The follow-up after 1 month showed that the coronary artery diameter returned to normal. This article summarizes the experience in the treatment of incomplete Kawasaki disease with no response to IVIG in order to reduce the incidence of coronary artery damage.

Asperfloketals A and B, the First Two Ergostanes with Rearranged A and D Rings: From the Sponge-Associated Aspergillus flocculosus 16D-1.

Asperfloketals A (1) and B (2), two 1(10 → 6)-abeo-14,15-secosteroids featuring a novel trioxahexaheterocyclic ring system, were isolated from the sponge-associated fungus Aspergillus flocculosus 16D-1. Their structures were elucidated by extensive spectroscopic analysis and NMR chemical shifts calculations, supported by DP4+ probability analysis, and their absolute configurations were determined by ECD calculations and the modified Mosher's method. Asperfloketals A and B showed strong anti-inflammatory activity in the CuSO4-induced transgenic fluorescent zebrafish but displayed no cytotoxicity against HeLa, HepG2, and SW480 cell lines.

[Interpretation of the JCS/JSCS 2020 guideline on diagnosis and management of cardiovascular sequelae in Kawasaki disease].

Kawasaki disease is the main cause of acquired heart disease in children. The cardiovascular sequelae of Kawasaki disease, such as coronary artery lesion and giant coronary aneurysm, have a great impact on children's physical and mental health. The Japanese Circulatory Society and the Japanese Society of Cardiac Surgery jointly released the JCS/JSCS 2020 guideline on diagnosis and management of cardiovascular sequelae in Kawasaki disease in July, 2020, which systematically introduces the advances in the diagnosis and management of cardiovascular sequelae of Kawasaki disease. The article gives an interpretation in the severity evaluation of Kawasaki disease and diagnosis, treatment and long-term management of cardiovascular sequelae in the guideline.

[Kawasaki disease - a new manifestation of COVID-19 in children].

Since the outbreak of coronavirus disease 2019 (COVID-19) in Europe and America, the incidence of Kawasaki disease has significantly increased, which has aroused concern among pediatricians and parents. COVID-19 can cause inflammation reactions of multiple organs, which is similar to the systemic vasculitis of Kawasaki disease, and even COVID-19 can cause skin rash on the extremities of the limbs, which is also similar to Kawasaki disease. The cause of Kawasaki disease is currently unclear, and it cannot be ruled out that COVID-19 is associated with an increased incidence of Kawasaki disease. Therefore, during the epidemic of COVID-19, if children have symptoms similar to Kawasaki disease, intravenous immunoglobulin is recommended as early as possible to reduce the incidence of coronary artery lesions.

[A review on the role of angiotensin-converting enzyme 2 in children with coronavirus disease 2019].

With the spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) all over the world, there is an increasing number of children with such infection. Angiotensin-converting enzyme 2 (ACE2), one of the binding sites for SARS-CoV-2 infection in humans, can bind to viral spike proteins, allowing transmembrane serine protease (TMPRSS2) to activate S-protein to trigger infection and induce the production of various inflammatory factors such as interleukin-1, interferon-l, and tumor necrosis factor. Compared with adults, children tend to have lower expression levels of ACE2 and TMPRSS2, which are presumed to be associated with milder symptoms and fewer cases in children. The article summarizes the research advances in the role of ACE2 during SARS-CoV-2 infection, in order to help understand the pathogenic mechanism of SARS-CoV-2 and provide a reference for better development of drugs and vaccines to prevent and treat coronavirus disease 2019 in children.

Asperflotone, an 8(14→15)- abeo-Ergostane from the Sponge-Derived Fungus Aspergillus flocculosus 16D-1.

A novel 8(14→15)- abeo-ergostane-type steroid, asperflotone (1), and an ergostane steroid, asperfloroid (2), were isolated from the solid culture of Aspergillus flocculosus 16D-1. Their structures and absolute configurations were determined by high-resolution electrospray ionization mass spectrometry, 1D/2D NMR, X-ray crystallography, and quantum chemical calculations. Compound 1 is an unprecedented ergosteroid featuring a rearranged bicyclo[4.2.1]non-2-ene ring system that could result from α-ketol rearrangement during biosynthesis. Compounds 1 and 2 showed inhibitory activity toward IL-6 production in the induced THP-1 cells.

Preussins with Inhibition of IL-6 Expression from Aspergillus flocculosus 16D-1, a Fungus Isolated from the Marine Sponge Phakellia fusca.

New pyrrolidine alkaloids, preussins C-I (1-7) and (11 R)/(11 S)-preussins J and K (8 and 9), were isolated from the sponge-derived fungus Aspergillus flocculosus 16D-1. The structures and configurations of these preussins were elucidated by detailed spectroscopic analysis, modified Mosher's method, and comparisons with literature data. These compounds showed strong to moderate inhibitory activity toward IL-6 production in lipopolysaccharide-induced THP-1 cells with IC50 values ranging from 0.11 to 22 µM, but were inactive against normal tumor cell lines and fungi.

Constituents with potent α-glucosidase inhibitory activity from Pueraria lobata (Willd.) ohwi.

One new flavone hydrate named lobatflavate (1), one new chromone named lobatchrosin (2), and one new isoflavone named 3S,4R-tuberosin (3), along with four known isoflavone analogues (4-7), were isolated from the traditional Chinese medicinal plant of Pueraria lobata (Willd.) ohwi. Their structures were elucidated by extensive spectroscopic methods of IR, UV, HR-ESI-MS, 1D and 2D NMR. The absolute configuration of 3 was determined by CD spectrum associated with TD-DFT calculation analysis. All compounds except for 2 were assayed the inhibitory activity against α-glucosidase. Every tested compound was proved to be more active than positive control of acarbose. Of which 1 and 4 showed significant activity with IC50 value of 1.79µM and 23.01µM (IC50 of acarbose was 1998.79µM). Enzyme kinetic experiments revealed that 1 was irreversible whereas 4 was reversible and non-competitive α-glucosidase inhibitors. Moreover, structure-activity relationship was discussed and the docking studies of 1, 3 and 4 were also carried out.

[Efficacy and safety of Choudongning capsule (CDN)in children with Tourette's syndrome of spleen deficiency and phlegm accumulation].

To evaluate the efficacy and safety of Choudongning (CDN)capsule in children with Tourette's syndrome of spleen deficiency and phlegm accumulation through a randomized double-blind three-arm controlled phase Ⅲ study in 588 patients from 8 hospitals. The included patients were randomly divided into test group, positive control group and placebo group at the ratio of 3∶1∶1. Patients in the test group orally took CDN capsules and simulated Tiapridal tablets; the patients in positive control group took Tiapridal tablets and simulated CDN capsules; whereas the patients in placebo group orally took the simulated agents of the above two drugs. The treatment course was 6 weeks for three groups. The global grading rates, YGTSS scores and its factor scores, the degree of social function damage, as well as traditional Chinese medicine syndrome efficacy were evaluated as the outcome measures on efficacy. The AEs/ADRs, vital signs and laboratory testing were observed as outcome measures on safety. The total effective rate of YGTSS was 75.92% in the test group, 72.65% in the positive control group, and 37.29% in the placebo group. Non inferiority test stands between the test group and the positive control group, and they were superior to placebo group in efficacy with statistical difference. Significant difference had also been found among the 3 groups in YGTSS tics score, motor tics score, vocal tics, degree of social function damage and traditional Chinese medicine syndrome efficacy. During the study, there were 5 (1.42%)ADRs in the test group, 10 (8.55%)in the positive control group and 3 (2.54%)in the placebo group. The incidence of ADRs in the test group was lower than that in the positive control group, with statistical difference. It is clear to say that CDN capsule can effectively treat the Tourette's syndrome of spleen deficiency and phlegm accumulation. Its efficacy is not inferior to the commonly used Tiapridal tablets, with even less adverse reactions, so it has clinical application value.

Application of artificial intelligence in the diagnosis and treatment of Kawasaki disease.

This editorial provides commentary on an article titled "Potential and limitations of ChatGPT and generative artificial intelligence (AI) in medical safety education" recently published in the World Journal of Clinical Cases. AI has enormous potential for various applications in the field of Kawasaki disease (KD). One is machine learning (ML) to assist in the diagnosis of KD, and clinical prediction models have been constructed worldwide using ML; the second is using a gene signal calculation toolbox to identify KD, which can be used to monitor key clinical features and laboratory parameters of disease severity; and the third is using deep learning (DL) to assist in cardiac ultrasound detection. The performance of the DL algorithm is similar to that of experienced cardiac experts in detecting coronary artery lesions to promoting the diagnosis of KD. To effectively utilize AI in the diagnosis and treatment process of KD, it is crucial to improve the accuracy of AI decision-making using more medical data, while addressing issues related to patient personal information protection and AI decision-making responsibility. AI progress is expected to provide patients with accurate and effective medical services that will positively impact the diagnosis and treatment of KD in the future.

Relationship between Kawasaki disease and abdominal pain.

This editorial presents an analysis of an article recently published in the World Journal of Clinical Cases. Kawasaki disease (KD) is a well-known pediatric vasculitis characterized by fever, rash, conjunctivitis, oral mucosal changes, and swelling of the extremities. This editorial aims to delve into the intricate relationship between KD and abdominal pain, drawing insights from recent research findings to provide a comprehensive understanding and potential avenues for future investigation.