Coronary artery calcification and risk of mortality and adverse outcomes in patients with COVID-19: a Chinese multicenter retrospective cohort study.

Background: Coronary artery calcification (CAC) is an independent risk factor of major adverse cardiovascular events; however, the impact of CAC on in-hospital death and adverse clinical outcomes in patients with coronavirus disease 2019 (COVID-19) remains unclear. Objective: To explore the association between CAC and in-hospital mortality and adverse events in patients with COVID-19. Methods: This multicenter retrospective cohort study enrolled 2067 laboratory-confirmed COVID-19 patients with definitive clinical outcomes (death or discharge) admitted from 22 tertiary hospitals in China between January 3, 2020 and April 2, 2020. Demographic, clinical, laboratory results, chest CT findings, and CAC on admission were collected. The primary outcome was in-hospital death and the secondary outcome was composed of in-hospital death, admission to intensive care unit (ICU), and requiring mechanical ventilation. Multivariable Cox regression analysis and Kaplan-Meier plots were used to explore the association between CAC and in-hospital death and adverse clinical outcomes. Results: The mean age was 50 years (SD,16) and 1097 (53.1%) were male. A total of 177 patients showed high CAC level, and compared with patients with low CAC, these patients were older (mean age: 49 vs. 69 years, P < 0.001) and more likely to be male (52.0% vs. 65.0%, P = 0.001). Comorbidities, including cardiovascular disease (CVD) ([33.3%, 59/177] vs. [4.7%, 89/1890], P < 0.001), presented more often among patients with high CAC, compared with patients with low CAC. As for laboratory results, patients with high CAC had higher rates of increased D-dimer, LDH, as well as CK-MB (all P < 0.05). The mean CT severity score in high CAC group was also higher than low CAC group (12.6 vs. 11.1, P = 0.005). In multivariable Cox regression model, patients with high CAC were at a higher risk of in-hospital death (hazard ratio [HR], 1.731; 95% CI 1.010-2.971, P = 0.046) and adverse clinical outcomes (HR, 1.611; 95% CL 1.087-2.387, P = 0.018). Conclusion: High CAC is a risk factor associated with in-hospital death and adverse clinical outcomes in patients with confirmed COVID-19, which highlights the importance of calcium load testing for hospitalized COVID-19 patients and calls for attention to patients with high CAC. Supplementary Information: The online version contains supplementary material available at 10.1007/s42058-021-00072-4.

Shared and specific patterns of structural and functional thalamo-frontal disturbances in manic and euthymic pediatric bipolar disorder.

Bipolar disorder (BD) is clinically defined by alternating depressive and manic episodes with a separated period of euthymia. Thalamo-frontal loop plays vital role in psychotic symptoms, altered motor control and executive difficulties in BD. It remains unclear that structural and functional alterations of thalamo-frontal loop among the different mood states in BD, especially in pediatric BD(PBD).Twenty manic PBD (mPBD), 20 euthymic PBD (ePBD) and 19 healthy controls (HCs) were included in the study. By analyzing the T1 images and fMRI signals, thalamus volume and frontal grey matter cortical thickness were tested, and functional connectivity (FC) between bilateral thalamus and frontal cortex was calculated. Relationship between clinical indices and thalamo-frontal FC was also evaluated in mPBD and ePBD adolescents.Compared to HCs, the cortical thickness of left middle frontal gyrus (MFG), bilateral superior frontal gyrus (SFG) was significantly decreased in both mPBD and ePBD patients, and volume of left thalamus and cortical thickness of right MFG significantly decreased in mPBD patients. Compared to that of the HCs and ePBD subjects, thalamo-frontal hyperconnectivity with MFG was found in mPBD, and compared with that of HCs, thalamo-frontal hypoconnectivity with precentral gyrus/SFG was found in ePBD. In ePBD patients, episode times positively correlated with FC values between thalamus and precentral gyrus.The findings of the present study demonstrate detailed knowledge regarding shared and specific structural and functional disruption in thalamo-frontal loop in mPBD and ePBD subjects. Thalamo-frontal abnormalities reported in adult BD subjects were also observed in adolescent BD patients, and thalamo-frontal dysfunction may be a crucial treatment target in BD.

FKBP5 haplotypes and PTSD modulate the resting-state brain activity in Han Chinese adults who lost their only child.

The stress-related gene FKBP5 has been related to dysregulated glucocorticoid receptor (GR) signaling, showing increased GR sensitivity in trauma-exposed subjects with post-traumatic stress disorder (PTSD) but not in those without PTSD. However, the neural mechanism underlying the effects of FKBP5 remains poorly understood. Two hundred and thirty-seven Han Chinese adults who had lost their only child were included. Four FKBP5 single nucleotide polymorphisms (rs3800373, rs9296158, rs1360780, and rs9470080) were genotyped. All 179 participants were successfully divided into three FKBP5 diplotype subgroups according to two major FKBP5 H1 and H2 yin yang haplotypes. Brain average spectral power was compared using a two-way (PTSD diagnosis and FKBP5 diplotypes) analysis of covariance within four separate frequency bands (slow-5, slow-4, slow-3, and slow-2). Adults with PTSD showed lower spectral power in bilateral parietal lobules in slow-4 and in left inferior frontal gyrus (IFG) in slow-5. There was significant FKBP5 diplotype main effect in anterior cingulate cortex (ACC) in slow-4 (H1/H1 higher than other two subgroups), and in precentral/postcentral gyri and middle cingulate cortex (MCC) in slow-3 (H2/H2 higher than other two subgroups). Also, there was a significant diagnosis × FKBP5 diplotype interaction effect in right parietal lobule in slow-3. These findings suggest that adults with PTSD have lower low-frequency power in executive control network regions. Lower power in ACC and greater power in the motor/sensory areas in FKBP5 high-risk diplotype group suggest a disturbance of emotional processing and hypervigilance/sensitization to threatening stimuli. The interaction effect of diagnosis × FKBP5 in parietal lobule may contribute to PTSD development.

Ag-HPBs by a coating-etching strategy and their derived injectable implants for enhanced tumor photothermal treatment.

Herein, we demonstrate a coating-etching strategy to directly synthesize hollow Prussian blue (PB) nanocubes with well-dispersed Ag nanoparticles (denoted as Ag-HPB). The method is accomplished by introduction of PB precursors, K3Fe(CN)6 and Fe3+ into a reaction system containing AgNO3 and ascorbic acid, in which a series reactions contain formation of Ag nanoparticles, coating of PB on the nanoparticles, and diffusion of Ag into the PB frameworks occur. The strategy for preparation of the hollow structured Ag-HPB is intrinsically simple and does not require pre-preparation of any sacrificial templates or toxic etching agents. The obtained Ag-HPB nanocubes possess uniform size (69 nm), well-defined hollow structure, strong near-infrared photothermal conversion capacity, and excellent photoacoustic and magnetic resonance imaging abilities. Furthermore, an injectable photothermal implants are prepared for the first time by mixing the Ag-HPB nanocubes with clinically used biological glue, which significantly enhance photothermal anti-tumor efficacy, showing great potential for clinical tumor treatment.

A Multifunctional PB@mSiO2-PEG/DOX Nanoplatform for Combined Photothermal-Chemotherapy of Tumor.

In this work, we design mesoporous silica-coated Prussian blue nanocubes with PEGyltation to construct multifunctional PB@mSiO2-PEG nanocubes. The PB@mSiO2-PEG nanocubes have good biocompatibility, excellent photothermal transformation capacity, in vivo magnetic resonance and photoacoustic imaging ability. After loading antitumor drug doxorubicin (DOX) in the PB@mSiO2-PEG nanocubes, the constructured PB@mSiO2-PEG/DOX nanoplatforms show an excellent pH-responsive drug release character within 48 h, namely, an ultralow cumulative drug release amount of 3.1% at pH 7.4 and a high release amount of 46.6% at pH 5.0. Upon near-infrared laser irradiation, the PB@mSiO2-PEG/DOX nanoplatforms show an enhanced synergistic photothermal and chemical therapeutic efficacy for breast cancer than solo photothermal therapy or chemotherapy.

Disrupted thalamic resting-state functional connectivity in patients with minimal hepatic encephalopathy.

BACKGROUND AND PURPOSE: Little is known about the role of thalamus in the pathophysiology of minimal hepatic encephalopathy (MHE). The purpose of this study was to investigate whether the thalamic functional connectivity was disrupted in cirrhotic patients with MHE by using resting-state functional magnetic resonance imaging (rs-fMRI). MATERIALS AND METHODS: Twenty seven MHE patients and twenty seven age- and gender- matched healthy controls participated in the rs-fMRI scans. The functional connectivity of 11 thalamic nuclei were characterized by using a standard seed-based whole-brain correlation method and compared between MHE patients and healthy controls. Pearson correlation analysis was performed between the thalamic functional connectivity and venous blood ammonia levels/neuropsychological tests scores of patients. RESULTS: The ventral anterior nucleus (VAN) and the ventral posterior medial nucleus (VPMN) in each side of thalamus showed abnormal functional connectivities in MHE. Compared with healthy controls, MHE patients demonstrated significant decreased functional connectivity between the right/left VAN and the bilateral putamen/pallidum, inferior frontal gyri, insula, supplementary motor area, right middle frontal gyrus, medial frontal gyrus. In addition, MHE patients showed significantly decreased functional connectivity with the right/left VPMN in the bilateral middle temporal gyri (MTG), temporal lobe, and right superior temporal gyrus. The venous blood ammonia levels of MHE patients negatively correlated with the functional connectivity between the VAN and the insula. Number connecting test scores showed negative correlation with the functional connectivity between the VAN and the insula, and between the VPMN and the MTG. CONCLUSION: MHE patients had disrupted thalamic functional connectivity, which mainly located in the bilateral ventral anterior nuclei and ventral posterior medial nuclei. The decreased connectivity between thalamus and many cortices, and basal ganglia indicated reduced integrity of thalamic RSN in MHE.

Impact of low versus conventional doses of chemotherapy during transcatheter arterial chemo-embolization on serum fibrosis indicators and survival of liver cancer patients.

OBJECTIVES: To explore the impact of low- vs conventional-dose chemotherapy via transcatheter arterial chemo-embolization (TACE) on serum fibrosis indicators and treatment efficacy of hepatocellular cancer patients (HCC). MATERIALS AND METHODS: Patients fulfilling the eligibility criteria were assigned to TACE in Group A (with low-dose chemotherapy) or Group B (conventional-dose chemotherapy). Four serum fibrosis related indicators, hyaluronic acid(HA), human pro-collagen type-III (hPC-III), laminin (LN), and collagen type-IV(IV-C) before TACE were compared with the values 7 days after TACE. The response rate and survival time were also compared between the two groups. RESULTS: Fifty patients with HCC were enrolled in this study, including 25 in Group A and 25 in Group B. No significant differences were detected between the two groups in the four indicators before TACE. After TACE, the value of the four serum indicators increased significantly in Group B. However, no significant differences regarding these four indicators were found in Group A after TACE. Significant differences were demonstrated between the two groups after TACE, but median survival time and 1 or 2 year overall survival rates did not differ (P>0.05). CONCLUSIONS: Low-, compared with conventional-dose chemotherapy exerts the same impact on the variation of fibrosis related indicators and has no influence on median survival time and survival rate after TACE in HCC patients.

[Ecological characteristics of different Pseudosciaena crocea culture models].

A comparative study was conducted on the ecological characteristics of different Pseudosciaena crocea culture models including monoculture P. crocea (F) and polyculture P. crocea with seaweed Gracilaria lichevoides (FG), benthos Perinereis aibuhitensis (FP), and G. lichevoides plus P. aibuhitensis (FGP) in land-based enclosures, with the sediment and water environment condition, culture benefit, and nitrogen (N) and phosphorus (P) reclaim efficiency analyzed. G. lichevoides could effectively remove the N and P in the water body. The water N and P concentrations in FG and FGP were significantly lower than those in F and FP, and the P utilization efficiency reached 33.8% - 34.0% of the total P input. P. aibuhitensis improved sediment environment condition. The sediment N and P concentrations in FP and FGP were lower than those in F and FG, and had significant differences between surface sediment (1-2 cm) and subsurface sediment (2-4 cm). Comparing with those in F, the total N, total P, and inorganic P in FP and FGP reduced by 8.9% -9.2% , 6.1% -6.3% and 8.0% -8.1%, respectively. P. aibuhitensis had a higher efficiency in reclaiming sediment P (7.5% -7.8% of the total P input), being able to effectively mitigate the P accumulation in sediment. Among the test models, FGP had the best material utilization efficiency and optimal resource benefit.

[Effects of zinc supplementation on zinc and calcium levels in serum and tissue in burned rats].

OBJECTIVE: To explore the effects of zinc supplementation on zinc and calcium levels in serum and tissue in burned rats. METHODS: Eighty SD rats were randomly divided into C group (control group without scald, n = 8), and N, W, H groups (each consisting of 24 rats), in which the rats were exposed to scalding resulting in partial thickness burns covering 15% of the total body surface area on the back, and then they were fed with diets containing zinc 40 microg/g in N and W groups, and 80 microg/g in H group. A cream containing zinc 761.1 microg/g was applied on the wound in W group at the same time. Eight rats of each group were sacrificed on day 1, 3 and 7 after scald respectively. Venous blood and samples of liver, femur and scald skin were harvested. Zinc and calcium contents in serum and tissues were determined with atomic absorption spectrophotometer. RESULTS: The serum Zn(2+) levels in N, W groups were lower than C group, however, it was obviously higher in H group (up to 16.2 micromol/L) on day 1 after scald. The liver Zn(2+) showed an increasing tendency in all groups, while Ca(2+) level declined in H group, but increased in N, W group. The bone Zn(2+) and Ca(2+) levels showed a progressive declination in all groups from day 1 to 7 after scald. The changes were more obviously in N group than H group (P < 0.05). The Zn(2+) content of the scalded skin increased obviously in H group on first day after scald and in W group on 7th day after scald. The Ca(2+) contents of scalded skin showed marked increases in all groups, especially in N group, but least in W group. CONCLUSION: There are obvious changes in Zn(2+) and Ca(2+) contents of serum and tissues after scald injury and zinc supplementation. The effects of zinc supplementation on calcium level in the tissue need to be further studied.