Severe Coagulation Dysfunction caused by Vitamin K Deficiency in an Elderly Patient.

BACKGROUND: Vitamin K deficiency can lead to severe coagulation dysfunction, which may be dangerous and fatal, especially in patients undergoing surgery. METHODS: We report an 84-year-old male patient with gallstones and cholecystitis who had a severe coagulation disorder without bleeding symptoms after endoscopic papillary balloon dilation for removal of bile duct stones. After vitamin K supplementation, the coagulation dysfunction was corrected the next day. RESULTS: In this case, long-term antibiotic treatment, inadequate diet, and abnormal liver function led to coagulation dysfunction. After vitamin K supplementation, the blood coagulation disorder was corrected and serious consequences were prevented. Significantly elevated coagulation function was considered to be caused by vitamin K deficiency. CONCLUSIONS: This case indicates that coagulation dysfunction caused by vitamin K deficiency may occur within a few days. Laboratory personnel should fully understand the risks of vitamin K deficiency in elderly patients undergoing surgery with severely restricted diet, impaired absorption, and long-term use of cephalosporin anti-inflammatory therapy, and promptly remind clinical doctors.

A Case of Pseudoelevation of Serum CA19-9 Level.

BACKGROUND: Carbohydrate antigen 19-9 (CA19-9) is usually synthesized by pancreatic and bile duct cells and is present in small amounts in serum. During the period of tumor disease, its serum level significantly increases, and it is the most widely used serum tumor marker for diagnosis and monitoring therapy of pancreatic cancer. METHODS: We reported a case of abnormal elevation of serum CA19-9. Considering the possibility of detection interference, we used heterophilic antibody blocking analysis, detection by different analysis systems, and polyethylene glycol (PEG) precipitation to evaluate the reliability of abnormally elevated CA19-9 concentration. RESULTS: Repeated measurements on the Roche Cobas 8000 system of another hospital significantly reduced the CA19-9 concentration, as did PEG precipitation. Therefore, the abnormally elevated level of CA19-9 in this patient is considered to be pseudoelevation caused by interferences. CONCLUSIONS: We suggest considering the presence of detection interference in cases with elevated CA19-9 levels but no related clinical manifestations to prevent false positives. PEG precipitation may be a simple and feasible solution to eliminate interference.

Systematic review of the risk of urolithiasis following parathyroidectomy in patients with primary hyperparathyroidism.

OBJECTIVE: Parathyroidectomy (PTX) is the conclusive therapy for primary hyperparathyroidism (PHPT), but its effect on the risk of urolithiasis is inconclusive. We comprehensively reviewed the currently available research to investigate the impact of PTX on the likelihood of urolithiasis among individuals suffering PHPT. METHODS: Internet-based articles in English language released on Cochrane, PubMed, Scopus, Web of knowledge, and Embase up to September, 2023 were comprehensively reviewed. Each publication in contrast to the incidence, occurrence, or recurrence of urolithiasis after PTX versus medical treatment in PHPT patients was included. The outcome with pooled relative risks (RRs) and corresponding 95% confidence intervals (CIs) was examined employing DerSimonian and Laird's model of random effects. To determine the range of the real effect size of a future study in 95% of all populations, a prediction interval (PI) was also established. RESULTS: Finally, ten studies involving 74,190 patients were included. Results from randomized-controlled trials (RCTs) and observational studies (OSs) both revealed that PTX did not substantially lessen the vulnerability of urolithiasis among individuals with PHPT (RCTs: pooled relative risk [RR] 0.42, 95%CI 0.13-1.41, p = 0.163; OSs: pooled RR 1.37, 95%CI 0.96 to 1.97, p = 0.084). The PI (RCT: 0.03 to 5.96; OSs: 0.44-4.20) containing 1.0 suggested the possibility of consistent results in future studies. Subgroup and sensitivity analyses supported the above findings, and no evidence showed publication bias. CONCLUSION: Our analysis from the available RCTs or OSs did not give adequate or exact proof that the average effect of PTX lowers the incidence of urolithiasis among PHPT persons based on the random-effects model. Future research shall take into account the common effect of PTX as well as the prerequisites of preventive stone procedures, which will further help us assess the effectiveness of PTX in reducing kidney calculus comorbidity and develop techniques to avoid stone sequelae in these individuals.

Association of hypoglycaemia with the risks of arrhythmia and mortality in individuals with diabetes - a systematic review and meta-analysis.

Background: Hypoglycaemia has been linked to an increased risk of cardiac arrhythmias by causing autonomic and metabolic alterations, which may be associated with detrimental outcomes in individuals with diabetes(IWD), such as cardiovascular diseases (CVDs) and mortality, especially in multimorbid or frail people. However, such relationships in this population have not been thoroughly investigated. For this reason, we conducted a systematic review and meta-analysis. Methods: Relevant papers published on PubMed, Embase, Cochrane, Web of Knowledge, Scopus, and CINHAL complete from inception to December 22, 2022 were routinely searched without regard for language. All of the selected articles included odds ratio, hazard ratio, or relative risk statistics, as well as data for estimating the connection of hypoglycaemia with cardiac arrhythmia, CVD-induced death, or total death in IWD. Regardless of the heterogeneity assessed by the I2 statistic, pooled relative risks (RRs) and 95% confidence intervals (CI) were obtained using random-effects models. Results: After deleting duplicates and closely evaluating all screened citations, we chose 60 studies with totally 5,960,224 participants for this analysis. Fourteen studies were included in the arrhythmia risk analysis, and 50 in the analysis of all-cause mortality. Hypoglycaemic patients had significantly higher risks of arrhythmia occurrence (RR 1.42, 95%CI 1.21-1.68), CVD-induced death (RR 1.59, 95% CI 1.24-2.04), and all-cause mortality (RR 1.68, 95% CI 1.49-1.90) compared to euglycaemic patients with significant heterogeneity. Conclusion: Hypoglycaemic individuals are more susceptible to develop cardiac arrhythmias and die, but evidence of potential causal linkages beyond statistical associations must await proof by additional specifically well planned research that controls for all potential remaining confounding factors.

Diabetes duration or age at onset and mortality in insulin-dependent diabetics: a systematic review and meta-analysis.

BACKGROUND: This meta-analysis was conducted given the contradictory findings from studies on the influence of diabetes duration or age at onset on mortality in patients with insulin-dependent diabetes mellitus (IDDM). METHODS: Electronic databases (PubMed, Embase, Cochrane, Web of Knowledge, Scopus, and CINHAL) were comprehensively searched to identify relevant studies until October 31, 2022. All of the selected articles contained statistics on hazard ratios, relative risks (RRs), or odds ratios, or data for estimating the association between diabetes duration or age at onset and total mortality in IDDM patients. Regardless the heterogeneity assessed by the I2 statistic, pooled RRs and 95% confidence intervals (CI) for total mortality were acquired via random effect meta-analysis with inverse variance weighting. RESULTS: This meta-analysis finally included 19 studies involving 122, 842 individuals. Both age at onset and diabetes duration were positively associated with an increased mortality rate in IDDM patients. Specifically, the pooled RRs for age at onset and diabetes duration were 1.89 (95%CI 1.43-2.50) and 1.89 (95%CI 1.16-3.09) respectively. Subgroup analyses revealed that only prepubertal onset was associated with a greater survival advantage than pubertal or postpubertal onset. CONCLUSIONS: The findings of this meta-analysis and systematic review suggest that a later age at onset or longer diabetes duration is associated with increased risk of total mortality in IDDM patients. However, this conclusion shall be interpreted with caution due to the possibility of residual confounding and be confirmed in the future by well-designed studies.

A Case of Pseudoelevation of Prostate Specific Antigen Level.

BACKGROUND: Prostate specific antigen (PSA) is an important marker for the diagnosis, monitoring and efficacy evaluation of prostate cancer. Therefore, the accuracy of PSA detection results is of great significance for the diagnosis and treatment of prostate cancer. METHODS: We reported a case with abnormally elevated PSA. The patient's serum samples were subjected to investigations for suspected interference. Interference studies included measurement of PSA on different analytical platforms, serial dilutions, heterophilic blocking tube (HBT) analysis and polyethylene glycol (PEG) precipitation. RESULTS: In this case, the abnormal increases in the results of PSA detected by Abbott i2000SR immune analyzer were considered to be the pseudoelevation caused by interferences, resulting in unnecessary prostate puncture examination. CONCLUSIONS: When the patient's PSA level is abnormally elevated, which is not consistent with the clinical diagnosis, we should consider immunological interference in PSA assays. Pretreatment with PEG may be an economical, simple, and feasible scheme for removing interference.

A False Insulin Level in a Patient with Insulin Autoimmune Syndrome: a Case Report.

BACKGROUND: Insulin autoimmune syndrome (IAS) is a rare condition in which spontaneous severe hypoglycemia without previous exposure to exogenous insulin, and is characterized by hyperinsulinemia and high titers of insulin autoantibodies (IAA). METHODS: This paper reports a case of IAS with false insulin test results due to the hook effect. RESULTS: The patient's blood samples were collected at 0, 30, 60, 120, 180 minutes for measurement of serum insulin after a 3-hour oral glucose tolerance test (OGTT). The results of serum insulin levels were 1,698.6 pmol/L at fasting, 1,633.05 pmol/L at 30 minutes post load, 1,691.14 pmol/L at 60 minutes post load, 1,780.67 pmol/L at 120 minutes post load, and 1,807.93 pmol/L at 180 minutes post load. Dilution and re-analysis of the specimens revealed that the actual insulin concentrations were 217,516 pmol/L at fasting, 228,456 pmol/L at 30 minutes post load, 250,474 pmol/L at 60 minutes post load, 273,266 pmol/L at 120 minutes post load, and 291,232 pmol/L at 180 minutes post load. The insulin level results before and after the dilution had significant discrepancies. It was the hook effect caused by the high concentration of insulin in the serum that made the first test inaccurate. CONCLUSIONS: Serum insulin in patients with IAS is abnormally elevated, and extremely high concentrations of it may have a hook effect during assay resulting in inaccurate results. The laboratory should analyze and review the test results in combination with the patient's clinical case data, to detect interference in time and avoid erroneous diagnosis and treatment of patients.

Sub-50 nm core-shell nanoparticles with the pH-responsive squeezing release effect for targeting therapy of hepatocellular carcinoma.

The development of drug delivery systems with high drug loading capacity, low leakage at physiological pH, and rapid release at the lesion sites remains an ongoing challenge. In this work, core-shell poly(6-O-methacryloyl-D-galactose)@poly(tert-butyl methacrylate) (PMADGal@PtBMA) nanoparticles (NPs) of sub-50 nm are facilely synthesized by reversible addition-fragmentation chain transfer (RAFT) soap-free emulsion polymerization with the assistance of 12-crown-4. A hydrophilic poly(methacrylic acid) (PMAA) core can then be revealed after deprotection of the tert-butyl groups, which is negatively charged and can adsorb nearly 100% of incubated doxorubicin (DOX) from a solution at pH 7.4. The physical shrinkage of PMAA chains below pH 6.0 endows the core with the squeezing effect, therefore realizing rapid drug release. It is demonstrated that the DOX release rate of PMADGal@PMAA NPs at pH 5 was 4 times that at pH 7.4. Cellular uptake experiments confirm the high targeting ability of the galactose modified PMADGal shell to human hepatocellular carcinoma (HepG2) cells. The fluorescence intensity of DOX in HepG2 cells is 4.86 times that of HeLa cells after 3 h incubation. Moreover, 20% cross-linked NPs show the highest uptake efficiency by HepG2 cells due to their moderate surface charge, size and hardness. In summary, both the core and the shell of PMADGal@PMAA NPs promise the rapid site-specific release of DOX in HepG2 cells. This work provides a facile and an effective strategy to synthesize core-shell NPs for hepatocellular carcinoma targeting therapy.

The journey of prochloraz pesticide in Citrus sinensis: Residual distribution, impact on transcriptomic profiling and reduction by plasma-activated water.

Prochloraz (PTIC) is a hazardous fungicide used worldwide on agricultural produce despite concerns about potential impacts on human health and environmental pollution. The residue of PTIC and its metabolite 2,4,6-trichlorophenol (2,4,6-TCP) in fresh produce has largely not been clarified. Herein, we address this research gap by examining residues of PTIC and 2,4,6-TCP in fruit of Citrus sinensis through a typical storage period. PTIC residue in the exocarp and mesocarp peaked on days 7 and 14, respectively, while 2,4,6-TCP residue gradually increased throughout storage period. Based upon gas chromatography-mass spectrometry and RNA-sequencing analysis, we reported the potential impact of residual PTIC on endogenous terpene production, and identified 11 DEGs encoding enzymes involved in terpene biosynthesis in Citrus sinensis. Additionally, we investigated both the reduction efficacy (max: 58.93%) of plasma-activated water in citrus exocarp and the minimal impact on quality attributes of citrus mesocarp. The present study not only sheds light on the residual distribution of PTIC and its impact on endogenous metabolism in Citrus sinensis, but also further provides theoretical basis for potential approaches for efficiently reducing or eliminating pesticide residues.

Differences in clinical characteristics and chest CT findings between severe and critical H1N1 pneumonia.

INTRODUCTION: Critical H1N1 pneumonia patients usually have one of the symptoms such as respiratory failure, septic shock, multiple organ dysfunction, or other need for intensive care management, which are associated with high risk of mortality. It is essential to differentiate the severity of H1N1 pneumonia and take corresponding target treatments. OBJECTIVES: We aim to investigate the differences in clinical characteristics and chest computed tomography (CT) findings between severe and critical patients with H1N1 pneumonia. METHODS: A total of 27 patients diagnosed with H1N1 pneumonia from October 2018 to March 2019 were retrospectively analyzed, and the differences in clinical manifestations, laboratory tests, and chest CT findings between the severe group (15 patients) and the critical group (12 patients) were compared. RESULTS: Frequency of dyspnea at rest was higher in critical group than that in severe group (P = 0.019). The neutrophil percentage was higher (P = 0.014) and the lymphocyte percentage was lower (P = 0.025) in critical compared with severe group. Bilateral lung involvement was the predominant pattern in both severe and critical patients, whereas the number of involved lobes in critical patients was more than that in severe patients (P = 0.024). Peripheral distribution was the predominant pattern in severe patients (40%), whereas more diffuse involvement of the lungs was observed in critical patients (83.30%). Ground-glass opacities and consolidation were the main CT findings in both groups, and prevalence of consolidation was higher in critical relative to severe group (83.30%). CONCLUSION: Compared with severe patients, those with critical H1N1 pneumonia were more likely to present with dyspnea at rest and decreased lymphocyte percentage. Chest CT showed that diffuse bilateral involvement and higher prevalence of consolidation are associated with critical outcomes.

Galactosylated Core-Shell Nanoparticles with pH/GSH Dual Sensitivity for Targeting Hepatocellular Carcinoma.

Galactosylated core-shell nanoparticles (NPs) with diameters of sub-50 nm were fabricated in one pot by reversible addition-fragmentation chain transfer (RAFT) soap-free emulsion polymerization. Their galactosylated shells and acidic cores endow them with high targeting and drug loading efficiencies, respectively. Morever, the physical shrinkage and cleavage of the disulfide cross-linked NPs can realize the rapid release of loaded doxorubicin (DOX) under pH 5.0 and reduced glutathione (GSH) conditions. The combination of these excellent properties resulted in an even lower IC50 of DOX-loaded NPs than free DOX, demonstrating that this platform would be promising in targeting the therapy of hepatocellular carcinoma.

Direct electrochemical detection of Cu(â ¡) ions in juice and tea beverage samples using MWCNTs-BMIMPF6-Nafion modified GCE electrodes.

Due to a small amount of Cu (Ⅱ) ions being beneficial and too much being harmful, it is necessary to establish a rapid and direct detection method. Herein, we reported a platform based on multiwalled carbon nanotubes (MWCNTs), 1-butyl-3-methylimidazolium hexafluorophosphate (BMIMPF6), and Nafion solution-modified glassy carbon electrode (GCE) for the direct electrochemical detection of Cu (II) ions. We used differential pulse anodic stripping voltammetry, including the electrodeposition of Cu (Ⅱ) ions on the modified GCE and subsequent anodic stripping. Under the optimum conditions, the linear range was 20 µg·L-1 âˆ¼ 950 µg·L-1, the limit of detection (LOD) was 16 µg·L-1, and the limit of quantification (LOQ) was 54 µg·L-1 for Cu (II). We realized the quantitative detection of Cu (Ⅱ) ions in juice and tea beverage without tedious pretreatment. The result showed that the sensor had good anti-interference and practicability for actual food samples.

Nanoporous electrode with stable polydimethylsiloxane coating for direct electrochemical analysis of bisphenol A in complex wine media.

Direct electrochemical analysis of bisphenol A (BPA) in alcoholic drinks without proper sample preparation is a major challenge. The current work reports a nanoporous electrode design with ultrathin polydimethylsiloxane (PDMS) coating grafted on the top of an indium tin oxide (ITO) electrode with silica nanochannels membrane and cetyltrimethylammonium bromide micelles (SNCM), using a facile contact heating step. The proposed PDMS@SNCM/ITO electrode was subjected to direct ultra-trace detection of BPA in the linear range of 1.0-100.0 µM and detection limit of 0.23 µM, under optimized pH 8 and an accumulation time of 9.0 min. The analytical utility of the proposed method was checked in real wine samples for BPA detection with successful recovery percentages in the range from 95.20 ± 8.53 to 96.22 ± 10.00. The intrinsic hydrophobic features, exceptional stability, and sensitivity of the proposed electrode show potential for food safety surveillance in complex food matrices.

In Vitro Activity of Delafloxacin and Finafloxacin against Mycoplasma hominis and Ureaplasma Species.

The in vitro activity of two new fluoroquinolones, delafloxacin and finafloxacin, were evaluated against M. hominis and Ureaplasma spp. The MICs of delafloxacin, finafloxacin, and two classical fluoroquinolones (moxifloxacin and levofloxacin) were tested against 29 M. hominis and 67 Ureaplasma spp. isolates using the broth microdilution method. The molecular mechanisms underlying fluoroquinolone resistance were also investigated. Delafloxacin exhibited low MICs against M. hominis and Ureaplasma spp., including the levofloxacin-resistant isolates. For M. hominis, delafloxacin showed low MIC90 value of 1 µg/mL (MIC range, <0.031 -1 µg/mL) compared to 8 µg/mL for finafloxacin, 16 µg/mL for moxifloxacin, and 32 µg/mL for levofloxacin. For U. parvum and U. urealyticum, delafloxacin had low MIC90 values (U. parvum, 2 µg/mL; U. urealyticum, 4 µg/mL) compared to 16 -32 µg/mL for finafloxacin, 16 µg/mL for moxifloxacin, and 32 - >32 µg/mL for levofloxacin. The two mutations GyrA S153L and ParC S91I were commonly identified in fluoroquinolone-resistant M. hominis, and ParC S83L was the most frequent mutation identified in fluoroquinolone-resistant Ureaplasma spp. Delafloxacin displayed lower MICs against fluoroquinolone-resistant isolates of both M. hominis and Ureaplasma spp. that have mutations in the quinolone resistance determining regions (QRDRs) than the two classical fluoroquinolones. Delafloxacin is a promising fluoroquinolone with low MICs against fluoroquinolone-resistant M. hominis and Ureaplasma spp. Our study confirms the potential clinical use of delafloxacin in treating antimicrobial-resistant M. hominis and Ureaplasma spp. infections. IMPORTANCE Fluoroquinolone resistance in Mycoplasma hominis and Ureaplasma spp. is on the rise globally, which has compromised the efficacy of the currently available antimicrobial agents. This study evaluated the antimicrobial activity of two new fluoroquinolones, delafloxacin and finafloxacin, for the first time, against M. hominis and Ureaplasma spp. clinical isolates. Delafloxacin and finafloxacin displayed different antimicrobial susceptibility profiles against M. hominis and Ureaplasma spp. in vitro. Delafloxacin was found to be more effective against M. hominis and Ureaplasma spp. than three classical fluoroquinolones (finafloxacin, moxifloxacin, and levofloxacin). Finafloxacin displayed activity similar to moxifloxacin but superior to levofloxacin against M. hominis and Ureaplasma spp. Our findings demonstrate that delafloxacin is a promising fluoroquinolone with outstanding activity against fluoroquinolone-resistant M. hominis and Ureaplasma spp.

Development and Validation of Prognostic Nomogram for Elderly Breast Cancer: A Large-Cohort Retrospective Study.

PURPOSE: Our research aims to study the bone metastatic patterns and prognostic outcomes in elderly breast cancer (BC) and to develop elder-specific nomograms. METHODS: We downloaded the data of BC patients between 2010 and 2016 from the Surveillance, Epidemiology, and End Results database. The differences in clinical features and prognosis between young (age < 65) and elderly (age ≥ 65) BC patients were compared. The univariate and multivariate Cox analyses were used to determine the overall survival (OS)- and cancer-specific survival (CSS)-related variables and establish two nomograms of BC patients with bone metastasis (BCBM). The receiver operating characteristic (ROC) curve with area under the curve (AUC), calibration curve, decision curve analysis (DCA), and Kaplan-Meier survival curve were selected to evaluate nomograms. RESULTS: A total of 230,177 BC patients were enrolled in our research, including 142,025 young and 88,152 elderly patients. The prognosis of elderly BCBM patients was significantly worse than young patients. Age, race, breast subtype, tumor size, tumor grade, brain metastasis, liver metastasis, surgery, and chemotherapy were independent prognostic variables for elderly BCBM patients, including OS and CSS. The AUC values at 12, 18, and 24 months were 0.750, 0.751, and 0.739 for OS nomogram and 0.759, 0.762, and 0.752 for CSS nomogram in the training cohort, which were higher than the AUC values of all single independent prognostic variables. The survival curve showed a distinct prognosis between low-, median- and high-risk groups (p < 0.001). Finally, calibration curves and DCA indicated that both nomograms have favorable performance. CONCLUSION: Elderly and young patients presented with different bone metastatic frequencies, clinical features, and prognostic outcomes. Two elder-specific nomograms incorporating nine clinical variables were established and validated to be a valuable predictor for elderly BCBM patients.

Differentiating thymoma, thymic carcinoma and lymphoma based on collagen fibre patterns with T2- and diffusion-weighted magnetic resonance imaging.

OBJECTIVES: The amount and distribution of intratumoural collagen fibre vary among different thymic tumours, which can be clearly detected with T2- and diffusion-weighted MR images. To explore the incidences of collagen fibre patterns (CFPs) among thymomas, thymic carcinomas and lymphomas on imaging, and to evaluate the efficacy and reproducibility of CFPs in differential diagnosis of thymic tumours. MATERIALS AND METHODS: Three hundred and ninety-eight patients with pathologically diagnosed thymoma, thymic carcinoma and lymphoma who underwent T2- and diffusion-weighted MR imaging were retrospectively enrolled. CFPs were classified into four categories: septum sign, patchy pattern, mixed pattern and no septum sign. The incidences of CFPs were compared among different thymic tumours, and the efficacy and reproducibility in differentiating the defined tumour types were analysed. RESULTS: There were significant differences in CFPs among thymomas, thymic squamous cell carcinomas (TSCCs), other thymic carcinomas and neuroendocrine tumours (OTC&NTs) and thymic lymphomas. Septum signs were found in 209 (86%) thymomas, which differed between thymomas and any other thymic neoplasms (all p < 0.005). The patchy, mixed patterns and no septum sign were mainly seen in TSCCs (80.3%), OTC&NTs (78.9%) and thymic lymphomas (56.9%), respectively. The consistency of different CFP evaluation between two readers was either good or excellent. CFPs achieved high efficacy in identifying the thymic tumours. CONCLUSION: The CFPs based on T2- and diffusion-weighted MR imaging were of great value in the differential diagnosis of thymic tumours. KEY POINTS: • Significant differences are found in intratumoural collagen fibre patterns among thymomas, thymic squamous cell carcinomas, other thymic carcinomas and neuroendocrine tumours and thymic lymphomas. • The septum sign, patchy pattern, mixed pattern and no septum sign are mainly seen in thymomas (86%), thymic squamous cell carcinomas (80.3%), other thymic carcinomas and neuroendocrine tumours (79%) and thymic lymphomas (57%), respectively. • The collagen fibre patterns have high efficacy and reproducibility in differentiating thymomas, thymic squamous cell carcinomas and thymic lymphomas.

Direct detection of Pb2+ and Cd2+ in juice and beverage samples using PDMS modified nanochannels electrochemical sensors.

Direct electrochemical detection in real food samples remains challenging due to the fouling and interference by abundant interference components. Herein, we report an electrochemical sensing platform based on binary assembly of silica nanochannels and polydimethylsiloxane that is able to detect Pb2+ and Cd2+ in real food samples without complex pretreatments. Using differential pulse anodic stripping voltammetry, the electrochemical detection consists of electro-deposition of metal species and subsequent anodic stripping in the modified silica-nanochannels. Under the optimized conditions, the linear ranges were obtained from 4 to 1500 µg L-1 for Pb2+ and 30 to 900 µg L-1 for Cd2+. The relative standard deviations were 2.9% and 3.6% for Pb2+ and Cd2+ of 300 µg L-1. Without tedious pretreatments, the quantitative detection of Pb2+ and Cd2+ in real juice and beverage samples was successfully performed, revealing that the developed sensor possesses excellent anti-interference and practicability properties for unprocessed food.

Interference-free Detection of Caffeine in Complex Matrices Using a Nanochannel Electrode Modified with Binary Hydrophilic-Hydrophobic PDMS.

In the present study, a novel electrochemical sensor for the direct detection of caffeine in the crude sample has been prepared by plasma-triggered polydimethylsiloxane (PDMS) deposition on the indium tin oxide electrodes supported with silica nanochannels. The deposited PDMS contains both the original hydrophobic and oxidized hydrophilic PDMS oligomers. Nanochannels modified with these two kinds of PDMS with opposite wettability only allow the passage of small amphiphilic molecules such as caffeine, while other molecules including hydrophilic, hydrophobic, and large ones were all rejected. With the excellent shielding properties, the modified nanochannel electrode exhibits excellent anti-interference and antifouling capability, which could be directly used for the detection of caffeine in real crude food such as tea, milk, coffee, and coke without sample pretreatments. Moreover, the modified electrode has good repeatability and stability. In contrast, severe interference was observed when conventional electrodes were used directly in these unprocessed samples. The linear ranges of caffeine were determined to be between 50 nmol/L and 700 µmol/L, with a limit of detection of 20 nmol/L. The developed sensor provides a very simple, rapid, and cost-effective way for the interference-free and fouling-free analysis of specific amphiphilic compounds and can be extended to a wide range of applications.

Distinguishing between COVID-19 and influenza during the early stages by measurement of peripheral blood parameters.

Coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 infection. This study aims to examine the changes in peripheral blood parameters during the early stages of COVID-19 and influenza. We analyzed the peripheral blood parameters of 169 COVID-19 patients and 131 influenza patients during the early-onset stage. Results from the patients with COVID-19 were compared with those from healthy controls and influenza patients. In addition, results from patients with common and severe COVID-19 were further compared. There were significant differences between COVID-19 and influenza patients in terms of age, white blood cell count, platelet count, percentage of neutrophils, percentage of lymphocytes, percentage of monocytes, percentage of eosinophils, percentage of basophils, neutrophil, count and monocyte count. Two parameters (monocyte count and percentage of basophils) were combined to clarify the diagnostic efficacy of COVID-19 and influenza and the area under the curve was found to be 0.772. Comparison of peripheral blood parameters from common COVID-19, severe COVID-19, and influenza patients revealed many differences during the early disease stages. The diagnostic formula developed by this study will be of benefit for physicians in the differentiation of COVID-19 and influenza.

Can the low and high b-value distribution influence the pseudodiffusion parameter derived from IVIM DWI in normal brain?

BACKGROUND: Our study aims to reveal whether the low b-values distribution, high b-values upper limit, and the number of excitation (NEX) influence the accuracy of the intravoxel incoherent motion (IVIM) parameter derived from multi-b-value diffusion-weighted imaging (DWI) in the brain. METHODS: This prospective study was approved by the local Ethics Committee and informed consent was obtained from each participant. The five consecutive multi-b DWI with different b-value protocols (0-3500 s/mm2) were performed in 22 male healthy volunteers on a 3.0-T MRI system. The IVIM parameters from normal white matter (WM) and gray matter (GM) including slow diffusion coefficient (D), fast perfusion coefficient (D*) and perfusion fraction (f) were compared for differences among defined groups with different IVIM protocols by one-way ANOVA. RESULTS: The D* and f value of WM or GM in groups with less low b-values distribution (less than or equal to 5 b-values) were significantly lower than ones in any other group with more low b-values distribution (all P <  0.05), but no significant differences among groups with more low b-values distribution (P > 0.05). In addition, no significant differences in the D, D* and f value of WM or GM were found between group with one and more NEX of low b-values distribution (all P > 0.05). IVIM parameters in normal WM and GM strongly depended on the choice of the high b-value upper limit. CONCLUSIONS: Metrics of IVIM parameters can be affected by low and high b value distribution. Eight low b-values distribution with high b-value upper limit of 800-1000 s/mm2 may be the relatively proper set when performing brain IVIM studies.