Effectiveness of enterovirus A71 vaccine against pediatric HFMD and disease profile of post-vaccination infection.

BACKGROUND: Vaccination has been proven effective against infection with enterovirus A71 (EV-A71) in clinical trials, but vaccine effectiveness in real-world situations remains incompletely understood. Furthermore, it is not clear whether previous vaccination will result in symptom attenuation among post-vaccinated cases. METHODS: Based on long-term data extracted from the only designed referral hospital for infectious diseases, we used a test-negative case-control design and multivariate logistic regression models to analyze the effectiveness of EV-A71 vaccine against hand, foot and mouth disease (HFMD). And then, generalized linear regression models were used to evaluate the associations between prior vaccination and disease profiles. RESULTS: We selected 4883 inpatients for vaccine efficacy estimations and 2188 inpatients for disease profile comparisons. Vaccine effectiveness against EV-A71-induced HFMD for complete vaccination was 63.4 % and 51.7 % for partial vaccination. The vaccine effectiveness was higher among cases received the first dose within 12 months. No protection was observed against coxsackievirus (CV) A6-, CV-A10- or CV-A16-associated HFMD among children regardless of vaccination status. Completely vaccinated cases had shorter hospital stay and disease course compared to unvaccinated cases (P < 0.05). CONCLUSIONS: These findings reiterate the need to continue the development of a multivalent vaccine or combined vaccines, and have implications for introducing optimized vaccination strategies.

Risk factors for one-year mortality following discharge in patients with acute aortic dissection: development and validation of a predictive model in a cross-sectional study.

PURPOSE: This study was aimed to identify the risk factors that influence the mortality risk in patients with acute aortic dissection (AAD) within one year after discharge, and aimed to construct a predictive model for assessing mortality risk. METHODS: The study involved 320 adult patients obtained from the Medical Information Mart for Intensive Care (MIMIC) database. Logistic regression analysis was conducted to identify potential risk factors associated with mortality in AAD patients within one year after discharge and to develop a predictive model. The performance of the predictive model was assessed using the receiver operating characteristic curve (ROC), calibration curve, and decision curve analysis (DCA). To further validate the findings, patient data from the First Affiliated Hospital of Guangxi Medical University (157 patients) were analyzed. RESULTS: Univariate and multivariate logistic regression analyses revealed that gender, length of hospital stay, highest blood urea nitrogen (BUN_max), use of adrenaline, and use of amiodarone were significant risk factors for mortality within one year after discharge (p < 0.05). The constructed model exhibited a consistency index (C-index) and an area under the ROC curve of 0.738. The calibration curve and DCA demonstrated that these indicators had a good degree of agreement and utility. The external validation results of the model also indicated good predictability (AUC = 0.700, p < 0.05). CONCLUSION: The personalized scoring prediction model constructed by gender, length of hospital stays, BUN_max levels, as well as the use of adrenaline and amiodarone, can effectively identify AAD patients with high mortality risk within one year after discharge.

Serum vascular endothelial growth factor and cortisol expression to predict prognosis of patients with hypertensive cerebral hemorrhage.

BACKGROUND: Cerebral hemorrhage is a common and severe complication of hypertension in middle-aged and elderly men. AIM: To investigate the correlation between vascular endothelial growth factor (VEGF) and cortisol (Cor) and the prognosis of patients with hypertensive cerebral hemorrhage. METHODS: A hundred patients with hypertensive intracerebral hemorrhage were enrolled from January 2020 to December 2022 and assigned to the hypertensive intracerebral hemorrhage group. Another 100 healthy people who were examined at our hospital during the same period were selected and assigned to the healthy group. Peripheral venous blood was collected, and serum Cor and VGEF levels were measured through enzyme linked immunosorbent assay. RESULTS: A statistically significant difference in serum Cor and VGEF levels was observed among patients with varying degrees of neurological impairment (P < 0.05). Serum Cor and VGEF levels were significantly higher in the severe group than in the mild-to-moderate group. Cor and VEGF levels were significantly higher in patients with poor prognoses than in those with good prognoses. Multiple logistic regression analysis revealed that serum Cor and VGEF levels were independent factors affecting hypertensive intracerebral hemorrhage (P < 0.05). CONCLUSION: Cor and VGEF are associated with the occurrence and development of hypertensive cerebral hemorrhage and are significantly associated with neurological impairment and prognosis of patients.

Multi-response assessment for carbon emission and hardening effect in laser surface quenching.

Laser surface quenching (LSQ) is gaining popularity in engineering applications, but it generates non-negligible carbon emissions. However, existing research mostly focuses on quenching performance. Little attention has been paid to carbon emissions of LSQ process. In this study, we build an experimental platform including fiber laser system (IPG YLR-4 kW) and carbon emission measurement system for a synergistic study of environmental impacts and processing quality in LSQ. Based on the L16 (43) Taguchi matrix, LSQ experiments are conducted on the shield disc cutter. The influences of laser power, scanning speed, and defocusing distance on carbon emissions and hardening effects are studied. The carbon emission efficiency of LSQ is analyzed and compared with the competitive technology. The geometry and the maximum average hardness (MAH) of LSQ high-hardness zone (HHZ) are studied. A comprehensive evaluation considering carbon emissions and hardening effects is conducted. The results show that the maximum value of carbon emission is 1.4 times the minimum value. The maximum depth and width of HHZ are respectively 0.507 and 3.254 mm. The maximum MAH is 3.5 times the hardness of base metal. Compared to the average experimental responses, the experiment with the highest comprehensive score respectively increases by 26.4%, 17.1%, and 30.3% in depth, width, and MAH of HHZ, and reduces by 5.8% in carbon emissions.

Hybrid evolutionary algorithm for stochastic multiobjective disassembly line balancing problem in remanufacturing.

With the development of the industrial economy and the accelerated renewal of products, many end-of-life products (EOL) have been generated to pollute our environment. This fact highlights the importance of recycling and remanufacturing EOL products as an active research topic. An efficient disassembly line is one solution for improving the remanufacturing and recycling processes of EOL products while reducing the environmental pollution. Although many optimization models and intelligent algorithms were developed to address the disassembly line balancing problem (DLBP), uncertainty was ignored by them. To alleviate the drawbacks of uncertainty for the disassembly operation, this study proposes a stochastic multi-objective optimization model for the DLBP minimizing the disassembly idle rate, smoothness, and energy consumption generated during the operation under uncertain operation time. Another novelty of this paper is to present an improved version of the northern goshawk optimization algorithm using a stochastic simulation method to solve the proposed model. The feasibility of the proposed model and the applicability of the developed algorithm are shown by two extensive examples. Finally, the performance of the proposed algorithm is revealed by a comparison with recent and state-of-the-art algorithms from the literature.

CircRNA circ_POSTN promotes the malignancy of glioma by regulating the miR-433-3p/SPARC axis.

Glioma is a common tumor in the brain. CircRNA hsa_circ_0030018, also termed as hsa_circPOSTN_001 (circ_POSTN), is reported to exert a promoting influence on the development of glioma. Our study intends to deeply explore its regulation mechanism of circ_POSTN. Expression of circ_POSTN, microRNA-433-3p (miR-433-3p) and Secreted protein acidic and rich in cysteine (SPARC) was detected by qRT-PCR or western blot assay. The function of circ_POSTN was analyzed by loss-of-function experiments. The targeting relationship between miR-433-3p and circ_POSTN or SPARC was predicted by bioinformatics analysis and validated by dual-luciferase reporter assay. Xenograft modeling was employed to validate the function of circ_POSTN in glioma in vivo. circ_POSTN and SPARC were upregulated while miR-433-3p was downregulated in glioma tissues and cells. Both circ_POSTN and SPARC knockdown inhibited clonogenicity, migration, and promoted apoptosis of glioma cells. Circ_POSTN sponged miR-433-3p to regulate SPARC expression. Gain of SPARC largely attenuated circ_POSTN knockdown or miR-433-3p overexpression-mediated effects on glioma cell clonogenicity, migration, and apoptosis. Furthermore, silencing of circ_POSTN decreased xenograft tumor growth in vivo. Inhibition of circ_POSTN repressed glioma development, at least in part, via regulating the miR-433-3p/SPARC axis, providing evidence for circ_POSTN as a potential therapeutic target for glioma.

Molecular epidemiology and clinical features of hand, foot and mouth disease requiring hospitalization after the use of enterovirus A71 inactivated vaccine in chengdu, China, 2017-2022: a descriptive study.

Three inactivated enterovirus A71 (EV-A71) vaccines have been widely vaccinated among children in the targeted age group in mainland China since mid-2016. However, comprehensive virological surveillance of hand, foot and mouth disease (HFMD) over multiple years after the use of EV-A71 vaccines has rarely been conducted. Using long-term data extracted from the Public Health and Clinical Center of Chengdu, we described the clinical, aetiological, and epidemiological characteristics of HFMD inpatients after the use of EV-A71 vaccines from 2017 through 2022. A total of 5115 patients were selected for analysis with a male-to-female ratio of 1.63:1 and were mostly under 5 years of age (97.6%). Among these cases, 4.3% presented with severe symptoms, and 4.1% of severe cases experienced significant complications. EV-A71 was no longer the major serotype for laboratory-confirmed HFMD, responsible for 15.6% of severe cases and 1.2% of mild cases. A significant downwards trend of EV-A71 infections was observed after the use of EV-A71 vaccines (P for trend < 0.001). Coxsackievirus A6 was the predominant pathogen, accounting for 63.5% of mild cases and 36.2% of severe cases. Coxsackievirus A10 (CV-A10) and A16 were sporadically detected, and an upwards trend was observed in the proportion of CV-A10 infections. This study provides baseline molecular epidemiology for the evaluation of EV-A71 vaccination impact and potential serotype replacement based on HFMD inpatients. Additional nationwide and population-based epidemiologic and serologic studies are essential to elucidate HFMD dynamics after the use of EV-A71 vaccines, and to inform public health authorities to introduce optimized intervention strategies.

Effect of Chaihu plus Longgu Muli decoction plus five-element music therapy in the treatment of cancer-related depression.

BACKGROUND: Ninety percent of tumour patients have negative emotions during or after anti-tumour treatment, resulting in depression. Western medicine antidepressants have many adverse reactions. Patients often discontinue antidepressants due to intolerance. AIM: This study aims to observe the clinical effect of Chaihu plus Longgu Muli decoction with five-element music therapy in treating cancer-related mild and moderate depression. METHODS: A total of 120 patients with depression in the Oncology Department of Tangshan Hospital of Traditional Chinese Medicine, Hebei Province, from July 2017 to March 2019, were selected and randomly divided into the control and study groups (60 cases each) by the random number table method. The study group was treated with Chaihu plus Longgu Muli decoction with five-element music therapy for depression. The control group was treated with escitalopram tablets. After three courses of treatment, the degree of depression, clinical efficacy, quality of life, serum norepinephrine (NE) and 5-hydroxytryptamine (5-HT) levels were observed. RESULTS: After treatment, the HAMD-24 (Hamilton Depression 24) scale scores of the study group (13.93 ± 6.32) were lower than the control group (19.04 ± 7.46), and the difference was statistically significant (x2 = 4.048, p = 0.008). The total effective rate of the study group (93.33%) was higher than the control group (73.33%), and the difference was statistically significant (x2 = 7.260, p = 0.000). After treatment, according to the QLQ-C30 (quality of life questionnaire) scale, the functional score of the study group was higher than the control group (p < 0.05), and the symptom score of the study group was lower than the control group (p < 0.05). After treatment, the serum NE and 5-HT levels in the study group were higher than the control group, and the difference was statistically significant (p < 0.05) (NE: 221.81 ± 31.14 vs 198.91 ± 29.97, t = 4.078, p = 0.000; 5-HT: 141.41 ± 20.35 vs 125.32 ± 14.58, t = 5.781, p = 0.000). CONCLUSION: Chaihu plus Longgu Muli decoction with five-element music therapy can effectively alleviate patients' cancer-related depression and improve their quality of life, which is worthy of promotion.

Dynamic changes of viral load and the duration of viral shedding in patients with hand, foot and mouth disease: a protocol for longitudinal study.

BACKGROUND: The duration of virus shedding is necessary for determining the infectious period. But there were few quantitative studies on the changes of viral load and the law of the viral shedding in hand foot and mouth disease (HFMD) patients has not yet been clarified. METHODS: This study will prospectively recruit coxsackievirus A10 (CV-A10), coxsackievirus A16 (CV-A16) and coxsackievirus A6 (CV-A6) infected inpatients from January 2022 to December 2022. A series of samples and questionnaire information will be collected regularly to establish the dynamic function relationship between time and viral load changes and a Bayesian multilevel model will be constructed to clarify the evolvement rules which reflect the dynamic changes of viral load and the duration of viral shedding in patients with HFMD. DISCUSSION: The results of this study is expected to further clarify the evolvement rules which reflect the dynamic changes of viral load and the duration of viral shedding in HFMD patients under the influence of related factors. It can also provide important evidence for the scientific definition of the infectious period and isolation period of HFMD in China.

The effect of levosimendan on right ventricular function in patients with heart dysfunction: a systematic review and meta-analysis.

Levosimendan exerts positive inotropic and vasodilatory effects. Currently, its effects on right heart function remain uncertain. This systematic review and meta-analysis is intended to illustrate the impacts of levosimendan on systolic function of the right heart in patients with heart dysfunction. We systematically searched electronic databases (PubMed, the Cochrane Library, Embase and Web of Science) up to November 30, 2020, and filtered eligible studies that reported the impacts of levosimendan on right heart function. Of these, only studies whose patients suffered from heart dysfunction or pulmonary hypertension were included. Additionally, patients were divided into two groups (given levosimendan or not) in the initial research. Then, RevMan5.3 was used to conduct further analysis. A total of 8 studies comprising 390 patients were included. The results showed that after 24 h of levosimendan, patients' right ventricular fractional area change [3.17, 95% CI (2.03, 4.32), P < 0.00001], tricuspid annular plane systolic excursion [1.26, 95% CI (0.35, 2.16), P = 0.007] and tricuspid annular peak systolic velocity [0.86, 95% CI (0.41, 1.32), P = 0.0002] were significantly increased compared to the control group. And there is an increasing trend of cardiac output in levosimendan group [1.06, 95% CI (- 0.16, 2.29), P = 0.09 ] .Furthermore, patients' systolic pulmonary arterial pressure [- 5.57, 95% CI (- 7.60, - 3.54), P < 0.00001] and mean pulmonary arterial pressure [- 1.01, 95% CI (- 1.64, - 0.37), P = 0.002] were both significantly decreased, whereas changes in pulmonary vascular resistance [- 55.88, 95% CI (- 206.57, 94.82), P = 0.47] were not significant. Our study shows that in patients with heart dysfunction, levosimendan improves systolic function of the right heart and decreases the pressure of the pulmonary artery.

Microsurgical clipping vs. arterial embolization in the treatment of ruptured anterior circulation aneurysms.

OBJECTIVE: We aimed to compare the efficacy of microsurgical clipping of intracranial aneurysms with that of arterial embolization in the treatment of ruptured anterior circulation aneurysms. METHODS: The clinical data of 68 patients treated in our hospital for ruptured anterior circulation aneurysms between January 2017 and March 2020 were analyzed retrospectively. According to the surgical methods, the patients were divided into two groups: the microsurgical clipping group (30 cases) and the arterial embolization group (38 cases). The following markers were compared between the two groups: Hunt-Hess classification (HHC) grading, aneurysm occlusion rate, and incidence of postoperative complications, length of hospital stay, hospitalization cost, and the scores of the Glasgow Outcome Scale, Modified Rankin Scale, and Barthel Index during the 6-months follow-up after hospital discharge. RESULTS: The cases of HHC grade I and II increased in both groups at hospital discharge (both P<0.05), and there was no intergroup difference in this marker (P>0.05). The complete occlusion rate in the microsurgical clipping group was higher than that in the arterial embolization group (P<0.05). Compared with the microsurgical clipping group, the arterial embolization group had shorter length of hospital stay and higher hospitalization cost (both P<0.05). There was no difference in the total incidence of postoperative complications between the two groups (P>0.05). However, the arterial embolization group had lower incidence of intracranial infection and higher incidence of vasospasm than the microsurgical clipping group (both P<0.05). During the follow-up, the arterial embolization group had better results in terms of the Modified Rankin Scale and Barthel Index results and had more patients with GOS score of 5 points than the microsurgical clipping group (all P<0.05). CONCLUSION: Both microsurgical clipping of intracranial aneurysms and arterial embolization can effectively treat ruptured anterior circulation aneurysms, and the short-term efficacy achieved by these two methods is similar. Compared with microsurgical clipping of intracranial aneurysms, arterial embolization can lead to shorter hospitalization, lower incidence of intracranial infection, and better patients' prognosis and quality of life after the operation. However, the microsurgical clipping of intracranial aneurysms can achieve higher complete occlusion rate, lower incidence of vasospasm, and lower hospitalization cost than arterial embolization.

Growth of in vitro Fusarium oxysporum f. sp. niveum in chemically defined media amended with gallic acid.

Gallic acid was artificially added to the media to grow Fusarium oxysporum f.sp.niveum to investigate its effect on the pathogenic fungus. Results indicate that gallic acid inhibited the growth of F. oxysporum f.sp.niveum. The colony diameter, the conidia germinating rate and the conidia yield were reduced by 5.7-22.9%%, 35.8-55.6% and 38.9-62.2% respectively. However, the virulence factors by the fungus were stimulated. The activity of pectinase, proteinase and cellulase increased by 12.3-627.8%, 11.8-41.2% and 0.5-325.0% respectively, while the activity of amylase increased slightly. The results suggest that gallic acid repressed growth but facilitated the relative pathogenicity of invading pathogens.