Fully connected-convolutional (FC-CNN) neural network based on hyperspectral images for rapid identification of P. ginseng growth years.

P. ginseng is a precious traditional Chinese functional food, which is used for both medicinal and food purposes, and has various effects such as immunomodulation, anti-tumor and anti-oxidation. The growth year of P. ginseng has an important impact on its medicinal and economic values. Fast and nondestructive identification of the growth year of P. ginseng is crucial for its quality evaluation. In this paper, we propose a FC-CNN network that incorporates spectral and spatial features of hyperspectral images to characterize P. ginseng from different growth years. The importance ranking of the spectra was obtained using the random forest method for optimal band selection. Based on the hyperspectral reflectance data of P. ginseng after radiometric calibration and the images of the best five VNIR bands and five SWIR bands selected, the year-by-year identification of P. ginseng age and its identification experiments for food and medicinal purposes were conducted, and the FC-CNN network and its FCNN and CNN branch networks were tested and compared in terms of their effectiveness in the identification of P. ginseng growth years. It has been experimentally verified that the best year-by-year recognition was achieved by utilizing images from five visible and near-infrared important bands and all spectral curves, and the recognition accuracy of food and medicinal use reached 100%. The FC-CNN network is significantly better than its branching model in the effect of edible and medicinal identification. The results show that for P. ginseng growth year identification, VNIR images have much more useful information than SWIR images. Meanwhile, the FC-CNN network utilizing the spectral and spatial features of hyperspectral images is an effective method for the identification of P. ginseng growth year.

Global research trends in sexual health care: A bibliometric and visualized study.

No Patient or Public Contribution, because the relevant data of this article comes from the literature database. PURPOSE: The present study aimed to investigate the trends and research status of sexual healthcare. METHODS: We searched the Web of Science database for relevant articles concerning sexual healthcare, published between 2009 and 31 December 2022. Data collected include: the number of publications, authors, journals, countries, institutions, keywords. VOSviewer and CiteSpace were used to conduct the bibliometric study and visualise the analysis. RESULTS: A total of 1450 publications were included. The number of publications on sexual healthcare shows a fluctuating upward trend, and a stable core group of authors has been formed. The Journal of Clinical Nursing published the most articles on sexual healthcare (140 publications). The United States of America published the most articles (723, 49.86%). The research institution with the highest number of publications is the University of São Paulo. According to the keyword, timeline view and prominence mapping analysis, we believe that 'Female sexual health', 'HIV', 'LGBT' and 'Sexual Healthcare Services' may be new research hotspots in the field of sexual healthcare. CONCLUSION: This study describes the research status of sexual healthcare research over the past 14 years. The findings of this study can provide helpful reference and guidance for the development trend and research direction of sexual healthcare.

Emerging trends of BCG immunotherapy for bladder cancer in last decade: a bibliometric and visualization analysis.

Background: One of the milestones in bacterial-mediated therapy for cancer, Bacillus Calmette-Guerin (BCG) has been used to treat bladder cancer (BC) for more than 30 years. BCG immunotherapy is now the standard of care for high-grade non-muscle invasive bladder cancer (NMIBC) following transurethral resection. Methods: We searched the Web of Science core collection (WoSCC) database and used bibliometric methods through CiteSpace (version 5.1.R6), VOSviewer (version 1.6.18) and R-Bibliometrix (version R 4.2.1) to analyze and discuss the current status and trends of BCG therapy of BC from 2012 to 2021 in terms of co-occurrence, co-polymerization and visualization. Results: A total of 2476 publications were found, with the majority coming from the United States and China. Over the last decade, overall yearly outputs have increased fivefold, from 117 papers in 2012 to 534 records in 2021. Most publications were produced by the University of Texas System. The authors, Ashish M. Kamat of the University of Texas-MD Anderson Cancer Center in the United States, and Shahrokh F. Shariat of Weill Cornell Medical College, were pioneers in this field with the most publications. The journals, Urologic Oncology Seminars and Original Investigations, Cancers and Frontiers in Oncology, have published a dramatic increase in the number of articles, and tumor and urology nephrology research directions have received the most attention from journals. Furthermore, recent research has concentrated on muscle-invasive bladder cancer (MIBC). BCG therapy mechanism, BCG dose and strains, targeted therapy and immune checkpoint inhibitors (ICIs) for BC were attractive research contents, with ICIs (PD-1, PD-L1) being the most popular study point in recent years. With more research on tumor immunology, screening for more reliable biomarkers for precision treatment, and the development of combination regimens of ICIs, targeted treatment of BC stem cells, and personalized BC therapies may be promising areas of immunotherapy research in the coming years. Conclusion: The results of this bibliometric study can provide the current status and research trends of BCG therapy for BC in the last decade, and also further complements the research content of bacterial-mediated cancer therapy.

Seasonal and daily variations in the occurence and outcomes of acute Stanford type A dissections: a retrospective single-center study.

BACKGROUND: To investigate the seasonal, monthly, and daily distributions of the incidence of Stanford type-A acute aortic dissection (TAAAD) and identify seasonality in the duration of hospital stay and in-hospital mortality of TAAAD in south-eastern China. METHODS: We enrolled patients diagnosed with TAAAD between 1 June 2017 and 31 May 2021. Participants were divided into seasonal, monthly, and daily groups according to the need for analysis. Analysis of variance was applied to compare the number of TAAAD in different seasons, months, and days. χ2 test was used to compare in-hospital mortality among the four groups. Non-parametric methods were used for all comparisons of the duration of hospital stay. Univariate logistic and multivariable logistic regression analyses were performed to assess the duration of hospital stay. RESULTS: Of the 485 patients, 154 were diagnosed in winter (31.8%), 115 in spring (23.7%), 73 in summer (15.1%), and 143 in autumn (29.5%). The daily, monthly, and seasonal distributions of TAAAD were significantly different (P = 0.04, P < 0.01, and P < 0.01, respectively). This study did not identify any significant decrease in maximal, mean, or minimum temperatures between the three days before TAAAD and the day of TAAAD. No seasonal variations associated with in-hospital mortality was observed (P = 0.89). However, significant differences were observed in the seasonal distribution of the duration of hospital stay for TAAAD [winter was 17.0 (4.0-24.0) days, spring was 20.0 (14.0-29.0) days, summer was 20.0 (12.5-31.0) days, and autumn was 20.0 (13.0-30.0) days, P < 0.01]. Multiple factor analysis showed that winter was the independent risk factor for the increased duration of hospital stay. The odds ratio for winter was 2.21 (1.46, 3.33, P < 0.01). CONCLUSIONS: Our study confirmed that the incidence of TAAAD exhibits seasonal, monthly, and daily variations in south-eastern China. Moreover, the daily incidence of TAAAD is higher on weekdays than that on weekends.

Comparison of valvuloplasty and replacement for surgical treatment of tricuspid infective endocarditis.

BACKGROUND: Owing to the increase in both intravenous drug injections and intracardiac and vascular interventional treatments among drug users, the incidence of infective endocarditis (IE) involving the tricuspid valve, which sits between the two right heart chambers, has gradually increased. This study aimed to compare the clinical outcomes of different surgical procedures for tricuspid infective endocarditis (TIE). METHODS: We retrospectively analyzed fifty-six patients who underwent tricuspid valve surgery at our hospital from January 2006 to August 2019. All patients were diagnosed with TIE and indicated a need for surgery. Perioperative and follow-up data were collected to summarize and analyze the clinical outcomes of different surgical approaches, including tricuspid valvuloplasty (TVP) and tricuspid valve replacement (TVR) for TIE. RESULTS: Cardiopulmonary bypass (CPB) time, aortic cross-clamp (ACC) time, postoperative mechanical ventilation time, and intensive care unit (ICU) stay time were shorter in the TVP group than in the TVR group. Additionally, the incidence of red blood cell transfusion and postoperative complications was lower in the TVP group than in the TVR group. The postoperative 30-day mortality rates were similar between both the groups. Fifty-two patients were followed up for an average of 5.50 ± 3.79 years. The postoperative 3-, 5-, and 7-year survival rates were 100%, 100%, and 95.5% in the TVP group and 96.7%, 96.7%, and 96.7% in the TVR group, respectively. The 5-year and 10-year reoperation rates were 0% and 0% in the TVP group and 6.7% and 20% in the TVR group, respectively. CONCLUSION: Both TVR and TVP for TIE significantly improved the functional status of the heart with satisfactory efficacy. TVP was found to be superior to TVR in reducing the need for postoperative blood transfusions, reducing the risk of postoperative complications, and reducing the need for long-term reoperations.

Thyroid hormone, cortisol, interleukin-2, and procalcitonin regulate postoperative delirium in acute type A aortic dissection patients.

BACKGROUND: We assessed the relationships between levels of preoperative thyroid hormone (TH), cortisol, interleukin-2 (IL-2), and procalcitonin (PCT) and postoperative delirium (POD) in acute type A aortic dissection (ATAAD) patients receiving modified triple-branched stent-graft (MTBSG) implant surgeries. METHODS: ATAAD patients received MTBSG implant surgeries in our hospital between February 2019 and December 2020 were recruited. We separated them into a POD and non-POD cohort and employed univariable and multivariable regression analysis to establish independent correlations between preoperative THs, cortisol, IL-2, and PCT and POD. In addition, we conducted stratification analyses to examine the link between pre-surgical THs and POD in normal TSH and lower TSH subgroups. RESULTS: POD occurred in 78 of 224 patients (34.8%). POD patients exhibited markedly reduced preoperative free triiodothyronine (FT3) (P = 0.008) and free thyroxine (FT4) (P = 0.023) levels, while remarkably enhanced preoperative cortisol (P < 0.001), IL-2 (P < 0.001), and PCT (P < 0.001) levels. Based on multivariate regression analysis, reduced preoperative FT3 (P = 0.032), as well as augmented preoperative IL-2 (P = 0.001), cortisol (P < 0.001), and PCT (P = 0.016) were strong stand-alone risk factors for POD. Moreover, subgroup analysis found the association between FT3 (P = 0.029), FT4 (P = 0.042) and POD was both significant in patients with normal TSH levels. CONCLUSIONS: Reduced preoperative FT3 and elevated preoperative cortisol, IL-2, and PCT were strong indicators of POD in ATAAD patients. Hence, we recommend that the thyroid function, cortisol, PCT, and IL-2 should be evaluated prior to surgery in ATAAD patients.

Fast Positioning Model and Systematic Error Calibration of Chang'E-3 Obstacle Avoidance Lidar for Soft Landing.

Chang'E-3 is China's first soft landing mission on an extraterrestrial celestial body. The laser Three-Dimensional Imaging (TDI) sensor is one of the key payloads of the Chang'E-3 lander. Its main task is to provide accurate 3D lunar surface information of the target landing area in real time for the selection of safe landing sites. Here, a simplified positioning model was constructed, to meet the accuracy and processing timeline requirements of the TDI sensor of Chang'E-3. By analyzing the influence of TDI intrinsic parameters, a permanent outdoor calibration field based on flat plates was specially designed and constructed, and a robust solution of the geometric calibration adjustment was realized by introducing virtual observation equations for unknowns. The geometric calibration and its absolute and relative positioning accuracy verification were carried out using multi-measurement and multi-angle imaging data. The results show that the error of TDI intrinsic parameters will produce a false obstacle with a maximum height of about 1.4 m on the plane, which will cause the obstacle avoidance system of Chang'E-3 to fail to find a suitable landing area or find a false flat area. Furthermore, the intrinsic parameters of the TDI have good stability and the accuracy of the reconstructed three-dimensional surface can reach about 4 cm after error calibration, which provides a reliable terrain guarantee for the autonomous obstacle avoidance of the Chang'E-3 lander.

Improvement of Myocardial Cell Injury by miR-199a-3p/mTOR Axis through Regulating Cell Apoptosis and Autophagy.

Background: Myocardial ischemia-reperfusion injury (MIRI) is characterized by its high incidence rate and mortality. miR-199a-3p is thought to be strongly linked with the development of some myocardial diseases, but the influence of miR-199a-3p in MIRI remains unclear. Methods: AC16 cells were used. The concentrations of mammalian target of rapamycin (mTOR), light chain 3 II/light chain 3 I, and Beclin-1 were detected with western blotting and qRT-PCR. The binding site between mTOR and miR-199a-3p was evaluated via luciferase report assay. Cell apoptosis was evaluated through flow cytometry. Results: Knockdown of miR-199a-3p accelerated the myocardial cell injury after L-oxygen treatment. Increased expression of mTOR and suppressed autophagy were observed after knockdown of miR-199a-3p. Knockdown of miR-199a-3p or overexpression of mTOR greatly aggravated cell injury through inhibiting autophagy. Conclusions. This study might be helpful for the therapeutic method of MIRI through by regulating miR-199a-3p/mTOR.

Preoperative clinical application of human fibrinogen in patients with acute Stanford type A aortic dissection: A single-center retrospective study.

OBJECTIVE: To evaluate the perioperative clinical efficacy of preoperative human fibrinogen treatment in patients with acute Stanford type A aortic dissection (ATAAD). METHODS: Data of 159 patients with ATAAD who underwent emergency surgical treatment in our hospital from January 2019 to December 2020 were retrospectively analyzed. Patients were divided into two groups according to whether human fibrinogen was administered before surgery: patients in group A received fibrinogen before surgery, while those in group B did not. The preoperative clinical data, surgical data, postoperative data, complications related to the coagulation function, and mortality of the two groups were compared and analyzed. RESULTS: The in-hospital mortality was similar in the two groups (2.9% vs. 9.3%, p = .122). However, group A had a significantly shorter operation time (279.24 ± 39.03 vs. 298.24 ± 45.90, p = .008), lower intraoperative blood loss (240.48 ± 96.75 vs. 353.70 ± 189.80, p < .001), and reduced intraoperative transfusion requirement of red blood cells (2.61 ± 1.18 vs. 6.05 ± 1.86, p < .001). The postoperative suction drainage within 24 h in group A was significantly decreased (243.24 ± 201.52 vs. 504.22 ± 341.08, p = .002). The incidence of postoperative acute kidney injury (AKI) in group A was lower than that in group B (3.8% vs. 14.8%, p = .023). Similarly, the incidence of postoperative hepatic insufficiency in group A was lower than that in group B (1.9% vs. 9.3%, p = .045). In group A, the mechanical ventilation time was shorter (47.68 ± 28.61 vs. 118.21 ± 173.16, p = .004) along with reduced intensive care unit stay time (4.06 ± 1.18 vs. 8.09 ± 9.42, p = .003), and postoperative hospitalization days (19.20 ± 14.60 vs. 23.50 ± 7.56, p = .004). CONCLUSION: Preoperative administration of human fibrinogen in patients undergoing ATAAD surgery can effectively reduce the intraoperative blood loss, amount of blood transfused, operation time, and postoperative complications, and improve the early prognosis of patients. In addition, this procedure is highly safe.

QUantitative and Automatic Atmospheric Correction (QUAAC): Application and Validation.

The difficulty of atmospheric correction based on a radiative transfer model lies in the acquisition of synchronized atmospheric parameters, especially the aerosol optical depth (AOD). At the moment, there is no fully automatic and high-efficiency atmospheric correction method to make full use of the advantages of geostationary meteorological satellites in large-scale and efficient atmospheric monitoring. Therefore, a QUantitative and Automatic Atmospheric Correction (QUAAC) method is proposed which can efficiently correct high-spatial-resolution (HSR) satellite images. QUAAC uses the atmospheric aerosol products of geostationary satellites to match the synchronized AOD according to the temporal and spatial information of HSR satellite images. This method solves the problem that the AOD is difficult to obtain or the accuracy is not high enough to meet the demand of atmospheric correction. By using the obtained atmospheric parameters, atmospheric correction is performed to obtain the surface reflectance (SR). The whole process can achieve fully automatic operation without manual intervention. After QUAAC applied to Gaofen-2 (GF-2) HSR satellite and Himawari-8 (H-8) geostationary satellite, the results show that the effect of QUAAC correction is slightly better than that of the Fast Line-of-sight Atmospheric Analysis of Spectral Hypercubes (FLAASH) correction, and the QUAAC-corrected surface spectral curves have good coherence to that of the synchronously measured by field experiments.

Clinical Nomogram for Predicting the Prognosis of Patients With Pulmonary Venous Obstruction After Total Anomalous Pulmonary Venous Connection Repair.

BACKGROUND: The aim of this study was to establish a nomogram to quantify the risk of postoperative pulmonary venous obstruction (PVO) and to make a scientific decision through the decision curve. METHODS: In total, 151 PVO patients with total anomalous pulmonary venous connection (TAPVC) repair in our hospital from December 2008 to December 2015 were involved in this study. A nomogram was generated based on the contribution weights of variables, which were found out by logistic analysis. The optimal clinical decision point was determined by the decision analysis and clinical impact curve, which could assess the net benefit between the nomogram and each independent risk factor for postoperative PVO. RESULT: Pulmonary venous obstruction with TAPVC repair was found to be positively and independently correlated with preoperative pulmonary hypertension, surgical methods, and preoperative pulmonary venous stenosis. CONCLUSIONS: The study introduced a novel model to aid in clinical decisions making for the patients with TAPVC individually, which may shed light on the evaluation of PVO risk.

Identification of immune-related cells and genes in the breast invasive carcinoma microenvironment.

The clinical prognosis of breast cancer is closely related to its infiltrating immune status. The study sought to explore tumor-infiltrating immune cells (TILs) and immune-associated genes in the tumor microenvironment of breast invasive carcinoma (BRCA). The ESTIMATE algorithm was used to evaluate the microenvironment of breast cancer patients in TCGA database. The tumor's matrix score and immune score were obtained. The median was divided into two sub groups according to the median of the score, and the correlation between the score and prognosis was also discussed. Differentially expressed genes were screened from two subgroups with high and low score of breast cancer, and the differentially expressed genes were analyzed by GO and KEGG enrichment to explore their possible molecular functions, biological processes, cellular components and signal pathways involved in gene enrichment. It was found that there was a significant correlation between immune score and five-year survival rate, and the high score group had a better prognosis. Macrophage M1 and T cell CD8+ cells were positively related to 5-year overall survival in patients with breast invasive carcinoma. However, Macrophage M2 was negatively related to 5-year overall survival. We also observed that the low expression of four genes (CLEC3A, MCTS1, PDP1 and TCP1,) was related to favorable survival outcomes. High expression of FOXP3, CXCL9, CCR5, CXCR3, and CD37 was related to a high overall survival rate in BRCA. We identified a list of immune - related cells and genes that are useful for Prognostic evaluation and individualized treatment of BRCA.

Construction of a TRFIC strip for rapid and sensitive detection of Ralstoniasolanacearum.

The development of a sensitive and rapid screening method for Ralstonia solanacearum is critical for the control of tobacco wilt. In the present study, tissue homogenates of three tobacco varieties (Honda, Yunnan 87 and K326) with different resistance to R. solanacearum, were individually used as additives to the bacteria culture medium. The changes in R. solanacearum secretome were investigated and one of the most abundant secretary proteins with increased expression, polygalacturonase (PG), was selected as a marker for R. solanacearum identification. Then PG gene was cloned into E. coli, and the expressed protein was used as the immunogen to develop monoclonal antibodies. Subsequently, the monoclonal antibody against PG was coupled with synthesized polystyrene microspheres, and a rapid test strip system was developed for the detection of R. solanacearum based on time-resolved fluorescent immunochromatographic (TRFIC) method. Under optimal conditions, the detection limit of the strips could reach 72 cells/mL; while it was 422 cells/mL with a linear range from 4 × 102 to 5.12 × 104 cells/mL when testing tobacco samples, which is 1000 times lower than that of colloidal gold-labeled strips. Notably, no cross-reactivity was observed with nine tobacco-related pathogens. Finally, this TRFIC strips was applied to detect R. solanacearum existed in the tobacco and soils of fields with or without bacterial wilt. The results demonstrated that this TRFIC strips could distinguish the difference in bacterial concentration existed in tobacco and soil between the two fields. In summary, this test strip is suitable for sensitive, quick screening of R. solanacearum in tobacco.

Blockade of TMEM16A protects against renal fibrosis by reducing intracellular Cl- concentration.

BACKGROUND AND PURPOSE: Renal fibrosis is the final common outcome in most forms of chronic kidney disease (CKD). However, the underlying causal mechanisms remain obscure. The present study examined whether transmembrane member 16A (TMEM16A), a Ca2+ -activated chloride channel, contributes to the progression of renal fibrosis. EXPERIMENTAL APPROACH: Masson staining, western blot and immunohistochemistry were used to measure renal fibrosis and related proteins expression. MQAE was used to evaluate the intracellular Cl- concentration. KEY RESULTS: TMEM16A expression was significantly up-regulated in fibrotic kidneys of unilateral ureteral obstruction (UUO) and high-fat diet murine models and in renal samples of IgA nephropathy patients. In vivo knockdown of TMEM16A with adenovirus harbouring TMEM16A-shRNA or inhibition of TMEM16A channel activity with inhibitors CaCCinh-A01 or T16Ainh-A01 effectively prevented UUO-induced renal fibrosis and decreased protein expression of fibronectin, α-SMA and collagen in the obstructed kidneys. In cultured HK2 cells, knockdown or inhibition of TMEM16A suppressed TGF-ß1-induced epithelial-mesenchymal transition, reduced snail1 expression and phosphorylation of Smad2/3 and ERK1/2, whereas overexpression of TMEM16A showed the opposite effects. TGF-ß1 increased [Cl- ]i in HK2 cells, which was inhibited by knockdown or inhibition of TMEM16A. Reducing [Cl- ]i significantly blunted TGF-ß1-induced Smad2/3 phosphorylation and profibrotic factors expression. The profibrotic effects of TGF-ß1 were also reduced by inhibition of serum- and glucocorticoid-inducible protein kinase 1 (SGK1). SGK1 was also suppressed by reducing [Cl- ]i. CONCLUSION AND IMPLICATIONS: Blockade of TMEM16A prevented the progression of kidney fibrosis, likely by suppressing [Cl- ]i/SGK1/TGF-ß1 signalling pathway. TMEM16A may be a potential new therapeutic target against renal fibrosis.

Mid-term outcomes of modified valve-sparing aortic root replacement versus the Bentall procedure for middle-aged Chinese patients with acute DeBakey I aortic dissection: a single-center retrospective study.

BACKGROUND: The mid-term and long-term efficacies of valve preservation in acute DeBakey I aortic dissection (AD) are controversial. Thus, it is unclear whether middle-aged patients with acute DeBakey I AD should undergo modified valve-sparing procedures or the Bentall procedure in an emergency setting. METHODS: This study included 213 middle-aged Chinese patients (under 60 years old) who were treated for acute DeBakey I AD between January 2009 and June 2015. The treatments involved modified valve-sparing aortic root replacement (VSARR) (117 patients) or the Bentall procedure (96 patients). Preoperative, intraoperative, postoperative, and follow-up data were analyzed. Echocardiography and thoracoabdominal computed tomography angiography (CTA) findings were reviewed at 3 months, 1 year, and then annually after surgery. RESULTS: No significant differences were observed in terms of the preoperative, intraoperative, in-hospital mortality, and postoperative parameters. There were also no significant differences in aortic regurgitation (AR). However, follow-up examinations using CTA revealed that 6 patients had endoleakage at the distal end of the triple-branched stent (0/110 patients [0.0%] vs. 6/90 patients [6.7%], P = 0.022). The anticoagulation-related thromboembolism/bleeding events was significantly lower in group A than in group B (0/110 patients [0.0%] vs. 11/90 patients [11.1%], P = 0.001). And postoperative aortic valve re-operation rate was significantly lower in group A (1/110 patients [0.9%] vs. 8/90 patients [8.9%], P = 0.020). There was no significant difference in survival during the follow-up period (log-rank P > 0.05). CONCLUSION: For middle-aged patients with acute DeBakey I AD, VSARR were associated with a lower rate of endoleakage at the distal end of the triple-branched stent, thromboembolism/bleeding events and aortic valve re-operation (vs. the Bentall procedure).

A Modified Approach with Caval Transection for Supracardiac Total Anomalous Pulmonary Venous Connection: Comparison Between Conventional and Sutureless Surgery in 173 Patients.

The efficacy of primary sutureless repair for supracardiac total anomalous pulmonary venous connection (TAPVC) needs to be confirmed. This study aimed to compare the long-term outcomes between the conventional surgery and the sutureless technique with a modified approach in superior TAPVC. Between January 2008 and December 2018, 173 patients with supracardiac TAPVC underwent surgery either with the conventional procedure (n = 130) or the sutureless repair (n = 43). Multivariate analysis and competing-risk analysis were used to identify risk factors for early death and postoperative pulmonary venous obstruction (PVO), respectively. Among 173 patients who underwent repair of supracardiac TAPVC, 46 (28%) had preoperative PVO, and 22 (12.7%) had postoperative PVO. The sutureless group had a lower postoperative PVO rate compared with the conventional group (p = 0.027). The risk factors for death were age ≤ 28 days [odds ratio (OR), 11.56; 95% confidence interval (CI) 1.33-100.47, p = 0.015], weight ≤ 3 kg (OR 9.57; 95% CI 1.58-58.09, p = 0.009), emergency operation (OR 19.24; 95% CI 3.18-116.35, p = 0.002), cardiopulmonary bypass time (OR 2.16; 95% CI 1.36-3.43, p = 0.003), cross-clamp time (OR 1.73; 95% CI 1.20-2.50, p = 0.022), and duration of ventilation (OR 1.11; 95% CI 1.02-1.21, p = 0.027). Age ≤ 28 days [Hazard Ratio (HR) 1.92; 95% CI 1.92-11.02, p < 0.001] and preoperative PVO (HR 41.70; 95% CI 8.15-213.5, p < 0.001) were associated with postoperative PVO. The sutureless repair is a reliable technique for supracardiac TAPVC. Age ≤ 28 days is associated with 30-day mortality and postoperative PVO.

Be aware of acute kidney injury in critically ill children with COVID-19.

BACKGROUND: Acute kidney injury (AKI) is a common complication of critically ill adult patients with COVID-19. However, currently, no studies investigate kidney impairment in children with COVID-19. We investigated incidence and treatment of AKI in pediatric patients with COVID-19 in Wuhan Children's Hospital during the early stages of the COVID-19 pandemic and discuss possible mechanisms of AKI related to SARS-CoV-2 infection. METHODS: By extracting data from electronic medical records, we conducted a retrospective observational study of kidney involvement in confirmed pediatric COVID-19 cases in Wuhan Children's Hospital during the coronavirus outbreak, from January 24 to March 20, 2020. Clinical presentations, clinical courses, laboratory findings, and medical interventions are described below. RESULTS: Among 238 confirmed COVID-19 cases, only three were critically ill and needed intensive care unit (ICU) admission. All three developed AKI, but AKI was not detected in any non-critically ill patients outside the ICU. Two of the three patients with AKI had prodromal gastrointestinal symptoms. Significantly elevated interleukin-6 (IL-6) levels and complement activation were observed in these patients with AKI. The three patients with AKI were treated with plasma exchange (PE) and continuous kidney replacement therapy (CKRT), resulting in one complete recovery, one partial recovery, and one mortality due to critical illness. CONCLUSIONS: Critically ill children with COVID-19 may develop AKI, especially following prodromal gastrointestinal symptoms. An inflammatory storm and complement-mediated injury may underlie AKI development in children with COVID-19. Our study supports implantation of PE and CKRT in management of critically ill patients with AKI.

Establishment and effect evaluation of an aortic dissection model induced by different doses of ß-aminopropionitrile in rats.

INTRODUCTION: Given the controversy regarding the appropriate dose of ß-aminopropionitrile for induction of aortic dissection models in rats, the purpose of this study was to explore the most suitable concentration of ß-aminopropionitrile to establish a high-incidence and low-mortality aortic dissection model. METHODS: Eighty three-week-old male Sprague-Dawley rats were equally divided into four groups: a control group, a 0.06% ß-aminopropionitrile group, a 0.08% ß-aminopropionitrile group and a 0.1% ß-aminopropionitrile group. Initial experiments were performed on the control group, which was not treated with ß-aminopropionitrile (and drank water freely), and the other three groups, which were given different concentrations of ß-aminopropionitrile solution daily (0.06%, 0.08% and 0.1%). Subsequently, on the 40th day, osmotic minipumps administering 1 µg/kg per min angiotensin II (Ang II) were implanted subcutaneously into the ß-aminopropionitrile groups, while the control group was continuously pumped with normal saline. The rats were euthanized 48 h after implantation. All rats that died before the expected end time of the experiment were autopsied immediately, and the aortas were dissected. The rats surviving at the end of the experiment were sacrificed by an overdose of sodium pentobarbital, and tissue samples were harvested for further analyses. RESULTS: The mean survival days were significantly different among the groups, with 39.1 ± 6.04 days in the 0.08% ß-aminopropionitrile group and 32.7 ± 9.85 days in the 0.1% ß-aminopropionitrile group (P = 0.0178) at the end of the experiment. Compared with those in the 0.06% ß-aminopropionitrile group, the rates of aortic dissection were significantly higher in the 0.08% ß-aminopropionitrile group and the 0.1% ß-aminopropionitrile group (P = 0.0015 and P = 0.0005, respectively), while there was no significant difference between the 0.08% ß-aminopropionitrile group and the 0.1% ß-aminopropionitrile group (P = 0.723) at 70% and 75%, respectively. However, the rupture rates were significantly different between the 0.08% ß-aminopropionitrile group and the 0.1% ß-aminopropionitrile group (55% versus 20%, P = 0.022). Hematoxylin-eosin staining of the aortic tissue sections of the ß-aminopropionitrile group showed that red blood cells entered the pseudocavity in the vascular wall, while the vascular wall structure of the control group was intact. Compared with control rats, which were intact and free from fracture, ß-aminopropionitrile-treated rats had fewer collagen fibers and exhibited fracture. Magnetic resonance imaging showed that the aortic intimae of the aortic dissection rats showed double lumens and intimal tears. CONCLUSIONS: An aortic dissection model with a high incidence and low mortality was successfully and stably developed with 0.08% ß-aminopropionitrile. This model will enable further studies investigating aortic dissection pathogenesis and drug therapy. Magnetic resonance imaging may be a reliable technique for imaging the aorta in rats.

Identification of miR-146a is Associated with the Aggressiveness and Suppresses Proliferation via Targeting CDKN2A in Breast Cancer.

There is emerging evidence that some microRNAs can promote or suppress several human cancer development and progression. However, the profile and molecular mechanism of microRNAs for human breast cancer is poorly unknown. We used bioinformatics approaches to find new candidate diagnostic and therapeutic miRNAs in human breast cancer via analysis of TCGA RNA sequencing data and publicly GEO microarray data, in order to provide theoretical basis for the future investigations of breast cancer. Decreased expression miR-146a was identified as a key regulator of human breast cancer development and progression. Interestingly, we founded that miR-146a expression levels dependent on tumor size and pathological grading in breast cancer patients, but not associated with other factors including age, T classification. Kaplan-Meier survival analysis showed that patients with high miR-146a expression had a longer survival rate than those low miR-146a expressions. In vitro assays of over-expression miR-146a induces cell cycle arrest and inhibits MDA-MB-231 cell proliferation. Furthermore, luciferase reporter gene assays demonstrated that miR-146a directly combine the 3-untranslated region of CDKN2A mRNA. In conclusion, we demonstrated miR-146a play an important role in breast cancer development and progression.