A rare condition similar to inguinal hernia in pregnancy: A case of bilateral varicose veins of round ligament of uterus.

Round ligament varicosities (RLV) are a very rare cause of an inguinal mass, which is very similar to an inguinal hernia, and should be taken seriously by women, especially in mid-pregnancy. Ultrasound can confirm the diagnosis of the RLV and can prevent unnecessary interventions. We report a case of a patient with bilateral RLV: the primigravida was 31 years old, G1P0, gestation 30+2w. The patient presented to the clinic 1 month ago due to the discovery of bilateral inguinal masses. After the diagnosis was confirmed by ultrasound, this patient received regular reviews during labor and delivery and is currently in good maternal condition. The patient came to the clinic 1 month after the discovery of bilateral inguinal area masses for 1 month.

Cord blood vitamin A and vitamin D levels in relation to physical growth in exclusively breastfed infants aged 0-6 months.

Background: Vitamins A and D are essential for the health of pregnant women and infants. Nevertheless, the relationship between umbilical cord blood vitamins A and D levels and the physical growth of exclusively breastfed infants remains uncertain. Objective: This cohort study aims to examine the relationship between cord blood vitamins A and D levels and the physical growth of exclusively breastfed infants aged 0-6 months. Methods: 140 singleton mother-infant pairs were recruited in total. Questionnaires were used to collect maternal and infant information, and liquid chromatography was utilized to quantify the levels of vitamins A and D in the umbilical cord blood. Anthropometric measurements were conducted at birth, at 3 and 6 months of age, and the weight-for-age z-score (WAZ), length-for-age z-score (LAZ), head circumference-for-age z-score (HAZ), and BMI-for-age z-score (BMIZ) were calculated. Univariate and multivariate linear regression models were used for the analysis. Results: The average concentration of vitamins A and D in cord blood was 0.58 ± 0.20 µmol/L and 34.07 ± 13.35 nmol/L, both below the normal range for children. After adjusting for confounding factors, vitamin A levels in cord blood positively correlated with HAZ growth in infants aged 3-6 months (ß= 0.75, P < 0.01) while vitamin D levels negatively correlated with LAZ growth (ß= -0.01, P = 0.01) and positively correlated with BMIZ growth (ß= 0.02, P < 0.01). Conclusion: Higher Vitamin A levels at birth promote HAZ growth in infants aged 3-6 months while higher vitamin D levels at birth promote BMIZ growth in infants aged 3-6 months. Clinical trial registration: https://register.clinicaltrials.gov, identifier NCT04017286.

Collagen is crucial target protein for scleral remodeling and biomechanical change in myopia progression and control.

In recent decades, the prevalence of myopia has been on the rise globally, attributed to changes in living environments and lifestyles. This increase in myopia has become a significant public health concern. High myopia can result in thinning of the sclera and localized ectasia of the posterior sclera, which is the primary risk factor for various eye diseases and significantly impacts patients' quality of life. Therefore, it is essential to explore effective prevention strategies and programs for individuals with myopia. Collagen serves as the principal molecule in the extracellular matrix (ECM) of scleral tissue, consisting of irregular collagen fibrils. Collagen plays a crucial role in myopia progression and control. During the development of myopia, the sclera undergoes a thinning process which is primarily influenced by collagen expression decreased and remodeled, thus leading to a decrease in its biomechanical properties. Improving collagen expression and promoting collagen crosslinking can slow down the progression of myopia. In light of the above, improving collagen expression or enhancing the mechanical properties of collagen fibers via medication or surgery represents a promising approach to control myopia.

Development and validation of a nomogram for predicting occurrence of severe case in children hospitalized with influenza A (H1N1) infection during the post-COVID-19 era.

Background: The significant rebound of influenza A (H1N1) virus activity, particularly among children, with rapidly growing number of hospitalized cases is of major concern in the post-COVID-19 era. The present study was performed to establish a prediction model of severe case in pediatric patients hospitalized with H1N1 infection during the post-COVID-19 era. Methods: This is a multicenter retrospective study across nine public tertiary hospitals in Yunnan, China, recruiting pediatric H1N1 inpatients hospitalized at five of these centers between February 1 and July 1, 2023, into the development dataset. Screening of 40 variables including demographic information, clinical features, and laboratory parameters were performed utilizing Least Absolute Shrinkage and Selection Operator (LASSO) regression and logistic regression to determine independent risk factors of severe H1N1 infection, thus constructing a prediction nomogram. Receiver operating characteristic (ROC) curve, calibration curve, as well as decision curve analysis (DCA) were employed to evaluate the model's performance. Data from four independent cohorts comprised of pediatric H1N1 inpatients from another four hospitals between July 25 and October 31, 2023, were utilized to externally validate this nomogram. Results: The development dataset included 527 subjects, 122 (23.1 %) of whom developed severe H1N1 infection. The external validation dataset included 352 subjects, 72 (20.5 %) of whom were eventually confirmed as severe H1N1 infection. The LASSO regression identified 19 candidate predictors, with logistic regression further narrowing down to 11 independent risk factors, including underlying conditions, prematurity, fever duration, wheezing, poor appetite, leukocyte count, neutrophil-lymphocyte ratio (NLR), erythrocyte sedimentation rate (ESR), lactate dehydrogenase (LDH), interleukin-10 (IL-10), and tumor necrosis factor-α (TNF-α). By integrating these 11 factors, a predictive nomogram was established. In terms of prediction of severe H1N1 infection, excellent discriminative capacity, favorable accuracy, and satisfactory clinical usefulness of this model were internally and externally validated via ROC curve, calibration curve, and DCA, respectively. Conclusion: Our study successfully established and validated a novel nomogram model integrating underlying conditions, prematurity, fever duration, wheezing, poor appetite, leukocyte count, NLR, ESR, LDH, IL-10, and TNF-α. This nomogram can effectively predict the occurrence of serious case in pediatric H1N1 inpatients during the post-COVID-19 era, facilitating the early recognition and more efficient clinical management of such patients.

Wide-Range Excitation-Dependent Phosphorescence of Coordination Polymers Exhibiting Dynamic Anticounterfeiting, White-Light Emission, and Antibacterial Performance.

Multicolor-tunable room-temperature phosphorescence (RTP) is attracting wide attention in optoelectronic applications. Here, we propose a coordination-oriented assembly approach to achieve wide-range RTP with a benzimidazole derivative (2,7-diazabenzimidazole, DZBIM) as a luminogen. These two compounds exhibit unexpected excitation-responsive RTP emission, and the phosphorescence emission nearly covers the entire visible region with the change of the excitation wavelength from 360 to 620 nm. To the best of our knowledge, this is the first report of coordination polymers with such a full-color-tunable RTP. Compound 1 also shows white-light emission upon excitation at 280 nm. Experimental and theoretical results demonstrate that multiple intermolecular interactions and emission centers from different aggregates are responsible for the generation of multicolor emission. The white-light emission and multiple anticounterfeiting are explored. Besides, compound 1 exhibits high antibacterial activity benefiting from efficient 1O2 generation. This work provides an efficient way to prepare a color-tunable RTP.

A novel AI-based diagnostic model for pertussis pneumonia.

It is still very difficult to diagnose pertussis based on a doctor's experience. Our aim is to develop a model based on machine learning algorithms combined with biochemical blood tests to diagnose pertussis. A total of 295 patients with pertussis and 295 patients with non-pertussis lower respiratory infections between January 2022 and January 2023, matched for age and gender ratio, were included in our study. Patients underwent a reverse transcription polymerase chain reaction test for pertussis and other viruses. Univariate logistic regression analysis was used to screen for clinical and blood biochemical features associated with pertussis. The optimal features and 3 machine learning algorithms including K-nearest neighbor, support vector machine, and eXtreme Gradient Boosting (XGBoost) were used to develop diagnostic models. Using univariate logistic regression analysis, 18 out of the 27 features were considered optimal features associated with pertussis The XGBoost model was significantly superior to both the support vector machine model (Delong test, P = .01) and the K-nearest neighbor model (Delong test, P = .01), with the area under the receiver operating characteristic curve of 0.96 and an accuracy of 0.923. Our diagnostic model based on blood biochemical test results at admission and XGBoost algorithm can help doctors effectively diagnose pertussis.

A novel combined nomogram for predicting severe acute lower respiratory tract infection in children hospitalized for RSV infection during the post-COVID-19 period.

Introduction: Off-season upsurge of respiratory syncytial virus (RSV) infection with changed characteristics and heightened clinical severity during the post-COVID-19 era are raising serious concerns. This study aimed to develop and validate a nomogram for predicting the risk of severe acute lower respiratory tract infection (SALRTI) in children hospitalized for RSV infection during the post-COVID-19 era using machine learning techniques. Methods: A multicenter retrospective study was performed in nine tertiary hospitals in Yunnan, China, enrolling children hospitalized for RSV infection at seven of the nine participating hospitals during January-December 2023 into the development dataset. Thirty-nine variables covering demographic, clinical, and laboratory characteristics were collected. Primary screening and dimension reduction of data were performed using Least Absolute Shrinkage and Selection Operator (LASSO) regression, followed by identification of independent risk factors for RSV-associated SALRTI using Logistic regression, thus finally establishing a predictive nomogram model. Performance of the nomogram was internally evaluated by receiver operating characteristic (ROC) curve, calibration curve, and decision curve analysis (DCA) based on the development dataset. External validation of our model was conducted using same methods based on two independent RSV cohorts comprising pediatric RSV inpatients from another two participating hospitals between January-March 2024. Results: The development dataset included 1102 patients, 239 (21.7%) of whom developed SALRTI; while the external validation dataset included 249 patients (142 in Lincang subset and 107 in Dali subset), 58 (23.3%) of whom were diagnosed as SALRTI. Nine variables, including age, preterm birth, underlying condition, seizures, neutrophil-lymphocyte ratio (NLR), interleukin-6 (IL-6), lactate dehydrogenase (LDH), D-dimer, and co-infection, were eventually confirmed as the independent risk factors of RSV-associated SALRTI. A predictive nomogram was established via integrating these nine predictors. In both internal and external validations, ROC curves indicated that the nomogram had satisfactory discrimination ability, calibration curves demonstrated good agreement between the nomogram-predicted and observed probabilities of outcome, and DCA showed that the nomogram possessed favorable clinical application potential. Conclusion: A novel nomogram combining several common clinical and inflammatory indicators was successfully developed to predict RSV-associated SALRTI. Good performance and clinical effectiveness of this model were confirmed by internal and external validations.

Expert consensus on the diagnosis and treatment of macrolide-resistant Mycoplasma pneumoniae pneumonia in children.

BACKGROUND: Mycoplasma pneumoniae (M. pneumoniae) is a significant contributor to community-acquired pneumonia among children. Since 1968, when a strain of M. pneumoniae resistant to macrolide antibiotics was initially reported in Japan, macrolide-resistant M. pneumoniae (MRMP) has been documented in many countries worldwide, with varying incidence rates. MRMP infections lead to a poor response to macrolide antibiotics, frequently resulting in prolonged fever, extended antibiotic treatment, increased hospitalization, intensive care unit admissions, and a significantly higher proportion of patients receiving glucocorticoids or second-line antibiotics. Since 2000, the global incidence of MRMP has gradually increased, especially in East Asia, which has posed a serious challenge to the treatment of M. pneumoniae infections in children and attracted widespread attention from pediatricians. However, there is still no global consensus on the diagnosis and treatment of MRMP in children. METHODS: We organized 29 Chinese experts majoring in pediatric pulmonology and epidemiology to write the world's first consensus on the diagnosis and treatment of pediatric MRMP pneumonia, based on evidence collection. The evidence searches and reviews were conducted using electronic databases, including PubMed, Embase, Web of Science, CNKI, Medline, and the Cochrane Library. We used variations in terms for "macrolide-resistant", "Mycoplasma pneumoniae", "MP", "M. pneumoniae", "pneumonia", "MRMP", "lower respiratory tract infection", "Mycoplasma pneumoniae infection", "children", and "pediatric". RESULTS: Epidemiology, pathogenesis, clinical manifestations, early identification, laboratory examination, principles of antibiotic use, application of glucocorticoids and intravenous immunoglobulin, and precautions for bronchoscopy are highlighted. Early and rapid identification of gene mutations associated with MRMP is now available by polymerase chain reaction and fluorescent probe techniques in respiratory specimens. Although the resistance rate to macrolide remains high, it is fortunate that M. pneumoniae still maintains good in vitro sensitivity to second-line antibiotics such as tetracyclines and quinolones, making them an effective treatment option for patients with initial treatment failure caused by macrolide antibiotics. CONCLUSIONS: This consensus, based on international and national scientific evidence, provides scientific guidance for the diagnosis and treatment of MRMP in children. Further studies on tetracycline and quinolone drugs in children are urgently needed to evaluate their effects on the growth and development. Additionally, developing an antibiotic rotation treatment strategy is necessary to reduce the prevalence of MRMP strains.

Application of CO2-Soluble Polymer-Based Blowing Agent to Improve Supercritical CO2 Replacement in Low-Permeability Fractured Reservoirs.

Since reservoirs with permeability less than 10 mD are characterized by high injection difficulty, high-pressure drop loss, and low pore throat mobilization during the water drive process, CO2 is often used for development in actual production to reduce the injection difficulty and carbon emission simultaneously. However, microfractures are usually developed in low-permeability reservoirs, which further reduces the injection difficulty of the driving medium. At the same time, this makes the injected gas flow very fast, while the gas utilization rate is low, resulting in a low degree of recovery. This paper conducted a series of studies on the displacement effect of CO2-soluble foaming systems in low-permeability fractured reservoirs (the permeability of the core matrix is about 0.25 mD). For the two CO2-soluble blowing agents CG-1 and CG-2, the effects of the CO2 phase state, water content, and oil content on static foaming performance were first investigated; then, a more effective blowing agent was preferred for the replacement experiments according to the foaming results; and finally, the effects of the blowing agents on sealing and improving the recovery degree of a fully open fractured core were investigated at different injection rates and concentrations, and the injection parameters were optimized. The results show that CG-1 still has good foaming performance under low water volume and various oil contents and can be used in subsequent fractured core replacement experiments. After selecting the injection rate and concentration, the blowing agent can be used in subsequent fractured cores under injection conditions of 0.6 mL/min and 2.80%. In injection conditions, the foaming agent can achieve an 83.7% blocking rate and improve the extraction degree by 12.02%. The research content of this paper can provide data support for the application effect of a CO2-soluble blowing agent in a fractured core.

In-situ revealed inhibition of W2C to excessive oxidation of CoOOH for high-efficiency alkaline overall water splitting.

The design of low-cost, efficient, and stable multifunctional basic catalysts to replace the high-cost noble metal catalysts remains a challenge. In this work, we report a dual-component Co-W2C catalytic system which achieves excellent properties of hydrogen evolution reaction (HER, η10 = 63 mV), oxygen evolution reaction (OER, η10 = 259 mV) and overall water splitting (η10 = 1.53 V) by adjusting the interfacial electronic structure of the material. Further density functional theory (DFT) calculations indicate that the efficient electronic modulation at the W2C/Co interface leads to the generation of favorable hydroxyl and hydrogen species energetics on the hybrid surface. The results of the in-situ Raman spectra show that W2C can suppress the excessive oxidation of the active site during the OER process, and the existence of core-shell structure also protects the W2C substrate. The stable and efficient catalytic performance of Co-W2C is attributed to the common advantages of structural and interface manipulation.

Harmine inhibits the proliferation and migration and promotes the apoptosis of colon cancer cells via inhibition of the FAK/AKT and ERK1/2/CREB signaling pathways.

Harmine is present in a variety of medicinal plants, and its effects on colon cancer cells remain unclear. Here, we found that harmine exhibited significant inhibitory effects on the proliferation of colon cancer cells by inhibiting the phosphorylation levels of the FAK/AKT and ERK1/2/CREB. Furthermore, harmine also inhibited the migration of colon cancer cells and suppressed the expression levels of MMP-2, MMP-9, and VEGF. Additionally, harmine-induced apoptosis in colon cancer cells by regulating the expression of Bcl-2 and Bax. In conclusion, our findings suggest that harmine exerts a significant inhibitory effect on the development of colon cancer cells.

scBlood: A comprehensive single-cell accessible chromatin database of blood cells.

The advent of single cell transposase-accessible chromatin sequencing (scATAC-seq) technology enables us to explore the genomic characteristics and chromatin accessibility of blood cells at the single-cell level. To fully make sense of the roles and regulatory complexities of blood cells, it is critical to collect and analyze these rapidly accumulating scATAC-seq datasets at a system level. Here, we present scBlood (https://bio.liclab.net/scBlood/), a comprehensive single-cell accessible chromatin database of blood cells. The current version of scBlood catalogs 770,907 blood cells and 452,247 non-blood cells from ∼400 high-quality scATAC-seq samples covering 30 tissues and 21 disease types. All data hosted on scBlood have undergone preprocessing from raw fastq files and multiple standards of quality control. Furthermore, we conducted comprehensive downstream analyses, including multi-sample integration analysis, cell clustering and annotation, differential chromatin accessibility analysis, functional enrichment analysis, co-accessibility analysis, gene activity score calculation, and transcription factor (TF) enrichment analysis. In summary, scBlood provides a user-friendly interface for searching, browsing, analyzing, visualizing, and downloading scATAC-seq data of interest. This platform facilitates insights into the functions and regulatory mechanisms of blood cells, as well as their involvement in blood-related diseases.

Evaluation of Higher-Order Aberrations After the Smooth Incision Lenticular Keratomileusis (SILKTM) Procedure Using the ELITATM Femtosecond Platform for Correction of Myopic and Astigmatic Refractive Errors.

Purpose: To evaluate the changes of higher-order wavefront aberrations following the Smooth Incision Lenticular Keratomileusis (SILKTM) procedure for correction of myopic refractive errors with and without astigmatism, using the ELITATM Femtosecond Platform. Methods: This prospective study included 24 eyes that underwent SILK procedure using one ELITA femtosecond laser system for the correction of myopic refractive errors with and without astigmatism. Preoperative and postoperative 1-day, 1-week, 1-month, 3-month, and 9-month eye exams were measured with a commercial wavefront aberrometer (iDESIGN ® Refractive Studio, Johnson & Johnson Surgical Vision, Inc). Wavefront aberrations up to the 6th order Zernike coefficients, including coma Z(3, -1) and Z(3, 1), spherical aberration Z(4, 1), and the wavefront error of all higher-order aberrations (HOAs RMS), were evaluated across a 6 mm pupil. Results: The mean manifest refractive spherical equivalent changed from the preoperative refractions -3.82 ± 1.26 D (range -6.00 to -2.25 D) to the postoperative refractions -0.20 ± 0.15 D (range -0.50 to 0.00 D) at the 9-month follow-up. Compared to baseline preoperative HOAs, the mean postoperative HOAs were significantly increased at the 1-day follow-up. On average, at the 9-month postoperative assessment the vertical coma Z(3, -1) was -0.054 ±0.186 µm, horizontal coma Z(3, 1) was 0.016 ± 0.124 µm, spherical aberration Z(4, 0) was 0.046 ± 0.163 µm, and HOAs RMS was 0.363 ± 0.115 µm across a 6 mm pupil. There is no significant difference in the mean HOAs starting at 1-week follow-up for the horizontal coma (P = 0.346) and spherical aberration (P = 0.095). Conclusions: The visual outcomes demonstrated that the SILK procedure for refractive lenticule extraction using ELITA femtosecond laser system is effective and predictable for the correction of myopic refractive errors with and without astigmatism. The ELITA femtosecond laser system induced minimal HOAs in surgical eyes following the SILK procedures. These results demonstrate fast corneal recovery starting at 1-week follow-up, and spherical aberration was not induced.

Synergistic effects of interface and phase engineering on telluride toward alkaline/neutral hydrogen evolution reaction in freshwater/seawater.

The development of efficient, stable, and versatile hydrogen evolution electrocatalysts is of great meaning, but still faces challenging. Interface engineering and phase engineering have been immensely applied in the field of hydrogen evolution reaction (HER) because of their unique physicochemical properties. However, they are typically used separately, which limits their effectiveness. Herein, we propose an interface-engineered CoMo/CoTe electrocatalyst, consisting of an amorphous CoMo (a-CoMo) layer-encapsulated crystalline CoTe array, achieving the profound optimization of catalytic performance. The experimental results and density functional theory calculations show that the d-band center of the catalyst shifts further upward in contrast with its crystalline-crystalline counterpart, optimizing the electronic structure and the intermediate adsorption, thereby reducing the kinetic barrier of HER. The a-CoMo/CoTe with superhydrophilic/superaerophobic features shows excellent catalytic performance in alkaline, neutral, and simulated seawater environments.

Selenium alleviates pancreatic fibrosis in chickens caused by mercuric chloride: Involvement of the MAPK signaling pathway and selenoproteins.

Mercuric chloride (HgCl2) is a widespread inorganic mercury with digestive toxicity. The pancreas is an important digestive organ in animals, and pancreatic fibrosis (PF) is a major pathological feature of chronic pancreatitis, which can be caused by heavy metals. Selenium (Se) is an essential trace element for the animal organism, performing biological functions in the form of selenoproteins, as well as alleviating the toxicity of heavy metals. In this study, we explored the specific mechanisms underlying the protective effect of Se on HgCl2-induced pancreatic injury in chickens. Morphological observation and serum biochemical analysis showed that Se attenuated HgCl2-caused pancreatic tissue damage and elevated glucose concentration and α-amylase activity. Next, the expression of oxidative stress indicators such as MDA and GSH-Px as well as inflammation-related markers including IL-1ß, IL-6, and TNF-α were detected. Results showed that Se had an inhibitory effect on HgCl2-induced oxidative stress and inflammation. Furthermore, we found that Se alleviated HgCl2-induced PF by detecting the expression of markers related to PF including TGF-ß1, α-SMA, COL1A1, and FN1. Mechanistically, Se attenuated HgCl2-induced PF via the MAPK signaling pathway. Importantly, several selenoproteins, especially those with antioxidant activity, were involved in the protective effect of Se on HgCl2 toxicity. In conclusion, our findings demonstrated that Se inhibited HgCl2-induced oxidative stress and inflammation and alleviated chicken PF through the MAPK signaling pathway, in which some antioxidant selenoproteins were involved.

Analysis of Risk Factors for Severe Acute Pancreatitis in the Early Period (<24 h) After Admission.

BACKGROUND: Severe acute pancreatitis (SAP) has high mortality. Early identification of high-risk factors that may progress to SAP and active intervention measures may improve the prognosis of SAP patients. OBJECTIVE: Clinical data within 24 h after admission were retrospectively analyzed to provide an evidence for early screening of high-risk factors in patients with SAP. METHODS: A review of clinical data of acute pancreatitis patients from January 1, 2018, to December 31, 2022, was conducted. We compared the clinical data of SAP and non-SAP patients, and a multivariable logistic regression model was used to identify the independent predictors of SAP. The receiver operating characteristic (ROC) curve of SAP was drawn for continuous numerical variables to calculate the optimal clinical cutoff value of each variable, and the predictive value of each variable was compared by the area under the ROC curve. RESULTS: Based on the multivariate logistic regression analysis of Age (odds ratio (OR), 1.032;95% confident interval (CI),1.018-1.046, p < 0.001), body mass index (BMI) (OR, 1.181; 95% CI,1.083-1.288, p < 0.001), Non-HTGAP (nonhypertriglyceridemic acute pancreatitis) (OR, 2.098; 95% CI,1.276-3.45, p = 0.003), white blood cell count (WBC) (OR,1.072; 95% CI,1.034-1.111, p < 0.001), procalcitonin (PCT) (OR, 1.060; 95% CI, 1.027-1.095, p < 0.001), serum calcium (Ca) (OR,0.121; 95% CI, 0.050-0.292, p < 0.001), computed tomography severity index (CTSI) ≥4 (OR,12.942;95% CI,7.267-23.049, p < 0.001) were identified as independent risk factors for SAP. The area under the ROC curve (AUC) and optimal CUT-OFF values of continuous numerical variables for predicting SAP were Age (0.6079,51.5), BMI (0.6,23.25), WBC (0.6701,14.565), PCT (0.7086, 0.5175), Ca (0.7787,1.965), respectively. CONCLUSION: Age, BMI, non-HTGAP, WBC, PCT, serum Ca and CTSI≥4 have good predictive value for SAP.