The causal relationship between obesity, obstructive sleep apnea and atrial fibrillation: a study based on mediated Mendelian randomization.

Background: Atrial fibrillation (AF) is a common cardiac arrhythmia that is associated with obesity and obstructive sleep apnea syndrome (OSA). Obesity and OSA may increase the risk of AF by affecting cardiovascular health. Methods: The study used the Mendelian randomization (MR) approach, combined with two-sample and multivariable analyses, to assess the relationships between obesity, OSA, and AF. The study utilized GWAS data and applied various statistical methods for the analysis. Results: The study found that obesity increased the risk of OSA, which in turn significantly increased the risk of AF. Through mediating MR analysis, it was found that OSA played a certain role in the causal relationship between obesity and AF, with about 6.4% of the risk of AF being mediated by OSA. Conclusion: This study highlights the relationships among obesity, OSA, and AF, providing useful guidance for future clinical researches.

The Influence of Precipitated Particles on the Grain Size in Cold-Rolled Al-Mn Alloy Foils upon Annealing at 100-550 °C.

The Al-Mn alloy heat exchanger fin production process includes a brazing treatment at s high temperature of 600 °C, in which coarse grains are preferred for their high resistance to deformation at elevated temperatures by decreasing the grain boundary sliding. In this study, Al-1.57Mn-1.57Zn-0.58Si-0.17Fe alloy foils cold rolled by 81.7% (1.1 mm in thickness) and 96.5% (0.21 mm in thickness) were annealed at 100-550 °C for 1 h to investigate their recrystallization behavior, grain sizes, and precipitates by increasing the annealing temperature, using micro-hardness measurement, electron back-scattered diffraction (EBSD), scanning electron microscopy (SEM), and transmission electron microscopy (TEM) techniques. The micro-hardness results showed that the recrystallization finishing temperatures for the two samples were almost the same, 323 ± 2 °C. The EBSD results showed that when the annealing temperature decreased from 550 to 400 °C, the recrystallized grain sizes of the two samples were nearly identical-both increased slightly. Further decreasing the annealing temperature from 400 to 330 °C caused the grain sizes to increase more, with the thinner foil sample having a more significant increase. The SEM and TEM observations showed that the micron-sized primary-phase remained unchanged during the annealing process. The nano-sized secondary phase precipitates formed during the hot-rolling process experienced a coarsening and dissolving process upon annealing. The particle size of the secondary phase increased from 32 nm to 44 nm and the area fraction decreased from 4.2% to 3.8%. The nucleation analysis confirmed that the large primary-phase could act as a nucleation site through particle stimulated nucleation (PSN) mode. The relatively dense secondary phase precipitates with small sizes at lower temperatures could provide higher Zener drag to the grain boundaries, leading to fewer nuclei and thereafter coarser grains. The coarsening of the recrystallized grains in the foils could be implemented through thickness reduction and/or precipitation processes to form densely distributed nano-sized precipitates.

Preliminary investigation on the analysis of the whole components of Pogejiuxin decoction and its formulation pattern based on ultrahigh-performance liquid chromatography with quadrupole time-of-flight mass spectrometry.

RATIONAL: Pogejiuxin decoction (PGJXD) is one of the most important formulas for the treatment of heart failure. However, there is a great lack of research on the material basis of this formula, especially research on its compatibility laws, which restricts its clinical use. Studying the complete ingredients and compatibility rules of PGJXD has great significance for guiding clinical medication. METHODS: The entire formula, the major single herbs, the drug pairs and the disassembled formula were analyzed by ultrahigh-performance liquid chromatography with quadrupole time-of-flight mass spectrometry (UHPLC/QTOFMS/MS), matching the chemical composition database and global natural product social molecular networking to explain the chemical composition as well as the combination pattern of PGJXD. RESULTS: A total of 1048 chemical constituents were fully analyzed from the major single herbs, the drug pairs and the disassembled formula and 188 chemical constituents, including 13 potential novel compounds, were firstly identified from the whole formula. We found that the chemical compositions were reduced after the single herbs were matched to the other herbs, especially the significant reduction of highly toxic diester alkaloids after compatibility, indicating that the medicines of PGJXD were interdependent and controlled by each other. CONCLUSION: This study innovatively researches and compares the compositional differences between the entire formula of PGJXD, the single, paired and separated formulas, greatly extending our understanding of the chemical substance basis of these compounds, and preliminarily explores the compatibility laws of PGJXD, providing some theoretical guidance for clinical medication.

Assessing energy saving potential of wavelength-dependent passive daytime radiative cooler implemented with EnergyPlus by a roof model.

The Passive Daytime Radiative Cooler (PDRC) exhibits potential in enhancing building energy conservation due to its high emissivity in wavelength between 8 µm and 13 µm. However, current building energy simulation programs, e.g., EnergyPlus, generally adopt a constant emissivity. To implement the wavelength-dependent PDRC model into EnergyPlus, a roof model was introduced to couple it with EnergyPlus to assess the energy saving potential of PDRC more reasonably. To assess the PDRC roofs, the impact of buildings constructed in different eras, building heights, and climatic conditions in China on building energy saving was investigated. The results showed that more energy was saved in regions with high cooling demands e.g., Shanghai and Guangzhou. Applying PDRC on roofs of buildings constructed pre 2001 in severe cold regions increased building energy consumptions. Furthermore, buildings with well insulated roofs coated by PDRC were not equally beneficial for reducing cooling demands in summer compared to buildings with non-insulated roofs, but heating demands in winter could be reduced. With an increase in building height, the energy saving potential of PDRC roofs was reduced. Therefore, a comprehensive analysis was imperative considering the local climates as well as the building itself when PDRC is to be applied.

Analysis of the clinical diagnosis and treatment of fetal meconium peritonitis.

BACKGROUND: The purpose of this study was to improve diagnostic and therapeutic standards by examining the clinical features, treatment, and prognosis of fetal meconium peritonitis (FMP), as well as the diagnostic efficacy of ultrasound for FMP. METHODS: The clinical data of 41 infants and pregnant women diagnosed with meconium peritonitis (MP) and treated at the Fujian Maternal and Child Health Hospital from January 2013 to January 2020 were analyzed retrospectively. Clinical data, imaging data, complications, treatment strategies, pregnancy outcomes, neonatal prognoses, and follow-up outcomes were all analyzed. RESULTS: The MP prenatal diagnosis rate was 56.1% (23/41), the neonatal surgery rate was 53.7% (22/41), and the survival rate was 85.4% (35/41). Intraperitoneal calcification (23 pregnant women, 56.1%), intestinal dilatation (13 pregnant women, 31.7%), peritoneal effusion (22 pregnant women, 53.7%), intraperitoneal pseudocyst (7 pregnant women, 17.1%), and polyhydramnios were diagnosed via prenatal ultrasound (18 pregnant women, 43.9%). Twenty-two pregnant women were assigned to the surgical treatment (operation) group, while 18 were assigned to the conservative treatment group. In the operation group, there were 9 cases of ileal atresia (40.9%), 7 cases of jejunal atresia (31.8%), 2 cases of atresia at the jejunum-ileum junction (9.1%), 2 cases of ileal perforation (9.1%), 1 case of ileal necrosis (4.5%), and 1 case of adhesive obstruction (4.5%). There was no statistically significant difference (p > .05) in the occurrence of various prenatal ultrasound findings by etiology. CONCLUSION: Multiple prenatal ultrasound markers have been identified for MP. To improve the efficacy of newborn treatment for FMP and reduce neonatal mortality, dynamic monitoring of ultrasound image alterations and strengthened integrated perinatal management are necessary.

To Draw a Detailed Map for Maxillofacial Fast-Flow Vascular Diseases With the Combination of Color Doppler Ultrasound and Three-Dimensional Computed Tomography Angiography.

Vascular diseases, such as vascular malformations and hemangiomas, are often classified into "fast-flow" and "slow-flow" based on their internal blood velocity. Fast-flow vascular diseases of maxillofacial regions are a kind of complicated and dangerous pathological changes originating from or containing arteries, their treatment is often complex and different from disease to disease, and large amounts of intraoperative blood loss and poor operation field may cause side injury or other problems without a detailed map of the lesion. The authors use the combination of color Doppler ultrasound and three-dimensional computed tomography angiography to diagnose and classify 36 cases of maxillofacial fast-flow vascular diseases, from January 2018 to December 2022 presented in the authors' department. Three-dimensional computed tomography angiography can display the location, type, and blood supply of lesions, whereas color Doppler ultrasound has unique advantages in identifying some special lesions (such as the colorful images of orificium fistulaes and the "Yin-yang sign" of pseudoaneurysms), then projecting and marking them on the body surface, which greatly facilitate the surgical procedure. This cost-effective and noninvasive combination shows significant clinical application value.

3D Temperature-Controlled Interchangeable Pattern for Size-Selective Nanoparticle Capture.

Patterned surfaces with distinct regularity and structured arrangements have attracted great interest due to their extensive promising applications. Although colloidal patterning has conventionally been used to create such surfaces, herein, we introduce a novel 3D patterned poly(N-isopropylacrylamide) (PNIPAM) surface, synthesized by using a combination of colloidal templating and surface-initiated photoinduced electron transfer-reversible addition-fragmentation chain transfer (SI-PET-RAFT) polymerization. In order to investigate the temperature-driven 3D morphological variations at a lower critical solution temperature (LCST) of ∼32 °C, multifaceted characterization techniques were employed. Atomic force microscopy confirmed the morphological transformations at 20 and 40 °C, while water contact angle measurements, upon heating, revealed distinct trends, offering insights into the correlation between surface wettability and topography adaptations. Moreover, quartz crystal microbalance with dissipation monitoring and electrochemical measurements were employed to detect the topographical adjustments of the unique hollow capsule structure within the LCST. Tests using different sizes of PSNPs shed light on the size-selective capture-release potential of the patterned PNIPAM, accentuating its biomimetic open-close behavior. Notably, our approach negates the necessity for expensive proteins, harnessing temperature adjustments to facilitate the noninvasive and efficient reversible capture and release of nanostructures. This advancement hopes to pave the way for future innovative cellular analysis platforms.

Structure and optical limiting effects of heterometallic Ag6@Ti12 and Ag8@Ti12 oxo clusters regulated by alkynyl ligands.

Heterometallic Ag6@Ti12 and Ag8@Ti12 oxo clusters were prepared through a strategy of protecting polynuclear silver cores by a hollow Ti-O module. The introduction of alkyne ligands has shown significant influence on their structures and optical limiting effects.

Circ_0068481 Affects the Human Pulmonary Artery Smooth Muscle Cells' Progression by miR-361-3p/KLF5 Axis.

BACKGROUND: Uncontrolled proliferation of pulmonary artery smooth muscle cells (PASMCs) contributes to the pathogenesis of pulmonary arterial hypertension (PAH). In this work, we defined the precise part of circ_0068481 in PASMC proliferation and migration induced by hypoxia. We hypothesized that circ_0068481 enhanced hypoxia-induced PASMC proliferation, invasion, and migration through the microRNA (miR)-361-3p/Krüppel-like factor 5 (KLF5) pathway. METHODS: Human PASMCs (hPASMCs) were exposed to hypoxic (3% O2) conditions. Circ_0068481, miR-361-3p, and KLF5 levels were gauged by qRT-PCR and western blot. Cell viability, proliferation, invasion, and migration were detected by XTT, EdU incorporation, transwell, and wound-healing assays, respectively. Dual-luciferase reporter, RNA immunoprecipitation, and RNA pull-down assays were performed to confirm the direct relationship between miR-361-3p and circ_0068481 or KLF5. RESULTS: Circ_0068481 expression was increased in the serum of PAH patients and hypoxia-induced hPASMCs. Downregulation of circ_0068481 attenuated hypoxia-induced promotion in hPASMC proliferation, invasion, and migration. Circ_0068481 directly targeted miR-361-3p, and miR-361-3p downregulation reversed the inhibitory effects of circ_0068481 silencing on hypoxia-induced hPASMC proliferation, invasion, and migration. KLF5 was a direct miR-361-3p target, and miR-361-3p upregulation mitigated hypoxia-induced hPASMC proliferation, invasion, and migration by inhibiting KLF5 expression. Moreover, circ_0068481-induced KLF5 expression by binding to miR-361-3p in hypoxic hPASMCs. CONCLUSIONS: Circ_0068481 knockdown ameliorated hypoxia-induced hPASMC proliferation, invasion, and migration at least in part through the miR-361-3p/KLF5 axis.

Synthesis and antibacterial activity evaluation of octapeptin derivatives / 药学学报

Octapeptin has strong antibacterial activity against Gram-negative bacteria such as Escherichia coli, Klebsiella pneumoniae and Acinetobacter baumannii, while it also has activity against some Gram-positive bacteria. This study used natural octapeptin A3 and B3 as lead compounds for structural modification. Twenty-one peptide derivatives (including A3 and B3) containing eight amino acid residues were prepared by solid-phase synthesis, and evaluated for antibacterial activity and renal cytotoxicity. Among them, three compounds 6, 7 and 17 exhibited broad-spectrum antibacterial activity and significantly enhanced the activity for Gram-positive bacteria while maintaining the activity of Gram-negative bacteria. Several compounds improved the activity for Pseudomonas aeruginosa. Compound 7 was active against all test strains and had relatively low renal cytotoxicity. The results provide a basis for the further development of novel polypeptide antibiotics.

The discriminatory diagnostic value of multimodal ultrasound combined with blood cell analysis for granulomatous lobular mastitis and invasive ductal carcinoma of the breast.

OBJECTIVE: To explore the discriminatory diagnostic value of multimodal ultrasound(US) combined with blood cell analysis(BCA) for Granulomatous Lobular Mastitis (GLM) and Invasive Ductal Carcinoma(IDC) of the breast. METHODS: A total of 157 breast disease patients were collected and divided into two groups based on postoperative pathological results: the GLM group(57 cases with 57 lesions) and the IDC group(100 cases with 100 lesions). Differences in multimodal ultrasound features and the presence of BCA were compared between the two groups. The receiver operating characteristic(ROC) curve was used to calculate the optimal cutoff values, sensitivity, specificity, 95% confidence interval(CI), and the area under the curve(AUC) for patient age, lesion size, lesion resistive index(RI), and white blood cell(WBC) count in BCA. Sensitivity, specificity, positive predictive value, negative predictive value, diagnostic accuracy, and AUC were calculated for different diagnostic methods. RESULTS: There were statistically significant differences(P <  0.05) observed between GLM and IDC patients in terms of age, breast pain, the factors in Conventional US(lesion size, RI, nipple delineation, solitary/multiple lesions, margin, liquefaction area, growth direction, microcalcifications, posterior echogenicity and abnormal axillary lymph nodes), the factors in CEUS(contrast agent enhancement intensity, enhancement pattern, enhancement range, and crab-like enhancement) and the factors in BCA(white blood cells, neutrophils, lymphocytes and monocytes). ROC curve analysis results showed that the optimal cutoff values for distinguishing GLM from IDC were 40.5 years for age, 7.15 cm for lesion size, 0.655 for lesion RI, and 10.525*109/L for white blood cells. The diagnostic accuracy of conventional US combined with CEUS(US-CEUS) was the highest(97.45%). The diagnostic performance AUCs for US-CEUS, CEUS, and US were 0.965, 0.921 and 0.832, respectively. CONCLUSION: Multifactorial analysis of multimodal ultrasound features and BCA had high clinical application value in the differential diagnosis of GLM and IDC.

Effect of the Solid Solution and Aging Treatment on the Mechanical Properties and Microstructure of a Novel Al-Mg-Si Alloy.

A novel Al-Mg-Si aluminum alloy with the addition of the micro-alloying element Er and Zr that was promptly quenched after extrusion has been studied. The solid solution and aging treatment of the novel alloy are studied by observing the microstructure, mechanical properties, and strengthening mechanism. Scanning electron microscopy (SEM) and transmission electron microscopy (TEM) techniques are employed to examine the changes in the microstructure resulting from various solid solution treatments and aging treatments. The best strengthening effect can be achieved when the solubility of the MgSi phase and precipitate ß″ (Mg2Si phase) is at their maximum. The addition of Er and Zr elements promotes the precipitation of the ß″ phase and makes the b″ phase more finely dispersed. The aging strengthening of alloys is a comprehensive effect of the dislocation cutting mechanism and bypass mechanism, the joint effect of diffusion strengthening of Al3(Er,Zr) particles and the addition of Er and Zr elements promoting the precipitation strengthening of ß″ phases. In this paper, by adding Er and Zr elements and exploring the optimal heat treatment system, the yield strength of the alloy reaches 437 MPa and the tensile strength reaches 453 MPa after solid solution treatment at 565 °C/30 min and aging at 175 °C/10 h.

Incidence and risk factors of acute kidney injury in patients with malignant tumors: a systematic review and meta-analysis.

BACKGROUND: There are significant differences in the incidence and risk factors of tumor patients, and there is no relevant statistical data. Therefore, this study aims to clarify the incidence and risk factors of acute kidney injury (AKI) in malignant tumor patients and compare critically ill patients with non-critically ill patients. METHODS: Relevant literature on the occurrence of AKI in malignant tumors was retrieved from databases. Two authors independently screened and evaluated the eligibility and quality of the literature and extracted the data. The Stata 12.0 software was used for meta-analysis. RESULTS: A total of 3922 articles were initially retrieved, and 24 articles were finally included, 8 of which were about critically ill malignant tumor patients, and 16 were about malignant tumor patients. Among the 4107 patients included in the 8 studies on critically ill malignant tumors, 1932 developed AKI, with an incidence rate of 52% (95%CI 34-70%, I2 = 99%). The risk factors for AKI in critically ill malignant tumor patients were sepsis and hypovolemia, which were different from those in non-critically ill patients. Among the 292,874 patients included in the 16 studies on malignant tumors, 51,211 developed AKI, and the combined incidence rate was 24% (95%CI 17-30%, I2 = 100%). The risk factors for AKI in critical malignant tumor patients were sepsis and hypovolemia. CONCLUSION: This meta-analysis shows that the incidence of AKI in critically ill malignant tumor patients is consistent with that in other critically ill patients, and independent risk factors are sepsis and hypovolemia. The incidence of AKI in malignant tumor patients is higher than that in other patients, and tumor is a risk factor for AKI. This study has been registered in INPLASY (INPLASY202320079),Registered February 18,2023.

Effect of spinal-pelvic sagittal balance on the clinical outcomes after lumbar fusion surgery.

BACKGROUND: Spinal-pelvic sagittal balance is important for maintaining energy-efficient posture in normal and diseased states.Few reports to date have evaluated the effect of spinal-pelvic sagittal balance on clinical outcomes after lumbar interbody fusion in patients with lumbar degenerative diseases (LDD). METHODS: A total of 303 patients treated with posterior lumbar interbody fusion surgery for lumbar degenerative disease from January 2012 to December 2019 were enrolled in this retrospective study according to the inclusion criteria. Preoperative and postoperative spinal-pelvic sagittal parameters including pelvic incidence (PI), pelvic tilt (PT), sacral slope (SS) and lumbar lordosis (LL) of the patients were evaluated and compared. 163 patients whose postoperative PI-LL ≤ 10° were divided into the spinal-pelvic match group (Group M), while 140 patients were divided into the spinal-pelvic mismatch group (Group MM). Preoperative and postoperative Oswestry Disability Index (ODI) and Visual Analog Scale (VAS) for back pain of both groups were compared. RESULTS: There was no significant difference between the two groups in demographic and surgical data, except for blood loss in surgery. LL, PI, PT and SS of the patients at final follow-up were all statistically different from the preoperative values in the two groups(P < 0.05). There was no significant difference in LL, PI, PT and SS between the two groups before surgery. At the final follow-up, LL, PI and PT differed significantly between the two groups(P < 0.05). Compared with the preoperative results, ODI and VAS of low back in both groups decreased significantly at the final follow-up (P < 0.05). Significant differences in VAS and ODI were found between the two groups at the final follow-up (P < 0.05). The improvement rates of VAS and ODI of Group M are both significantly higher than Group MM. Regression analysis showed that age and spinal-pelvic match had significant effects on the improvement of patients' low back pain at the final follow-up. CONCLUSIONS: lumbar interbody fusion can significantly improve the prognosis of patients with LDD. In terms of outcomes with an average follow-up time of more than 2 years, the spinal-pelvic match has a positive effect on patients' quality of life and the release of low back pain.

Resveratrol-Coated Gold Nanoflowers for CT Imaging and Apoptosis/Photothermal Synergistic Therapy of Malignant Melanoma.

In the past decade, photothermal therapy (PTT) of tumors based on gold nanomaterials has been widely studied because of their strong extinction ability and high photothermal conversion ability in the near-infrared (NIR) region. However, related research still faces two problems: First, the biosafety of the surface ligands on gold nanomaterials is not ideal and even has strong toxicity, so the surface modification or shell coating is very necessary; second, gold nanomaterials only have a single PTT function, which requires high temperature to achieve better treatment effect. Therefore, it is necessary to enrich the antitumor function of gold nanomaterials and realize synergistic therapy. Natural polyphenols can combine with each other or other substances through various supramolecular forces, forming shells on the surface of nanomaterials and reducing biotoxicity. In addition, natural polyphenols represented by resveratrol have antitumor activity and can induce apoptosis of tumor cells. Therefore, the surface coating method of gold nanomaterials with natural polyphenols with antitumor activity can effectively solve the above problems. In this work, we prepared resveratrol-coated gold nanoflowers (Au@Res NFs) and applied them to the treatment of malignant melanoma. Resveratrol in Au@Res NFs can induce the apoptosis of tumor cells, and Au@Res NFs can play a role in PTT under an NIR laser. In cell experiments, the synergistic effect of apoptosis/PTT on the A375 cells was extremely strong. In animal experiments, Au@Res NFs enriched in tumor sites identified the location and boundary of tumors by computed tomography (CT). The apoptosis induced by resveratrol had a certain inhibitory effect on tumor growth. Further applying the NIR laser, under the synergistic effect of apoptosis and PTT, the tumors were completely eliminated without recurrence during the experimental period.

Three decades of shade trees improve soil organic carbon pools but not methane uptake in coffee systems.

The rapid expansion of coffee plantations in tropical area at the cost of natural forest may suppress the methane (CH4) uptake and change the soil fertility. However, observations on soil CH4 uptake rates and the ecological consequence studies on coffee-based plantations are sparse. The objectives of this study were to characterize the dynamics of CH4 uptake among natural forest, coffee monoculture (CM), and coffee intercropping with shade tree (CI), and to evaluate the key drivers of soil CH4 uptake. Results showed that the conversion of forest into 25-year and 34-year CM plantations significantly reduced the soil organic carbon (SOC) content by 57% and 76%, respectively, whereas CI plantation profoundly increased the SOC by 20%-76% compared with CM plantation. Although soils of forest, CM and CI functioned exclusively as CH4 sinks, the CM and CI plantations significantly decreased the ambient CH4 uptake rates by 64%-83% due to soil moisture shift and soil nitrate availability by using chemical fertilizer. Interestingly, the potential CH4 uptake of CM and CI plantations did not decrease and in some treatments, was even higher than that of the natural forest. Potential CH4 uptake showed a negative correlation with soil pH and SOC content, but a positive correlation with soil available phosphorus (AP). Collectively, although the SOC and soil pH were increased through intercropping with shade trees for decades, the inhibition of atmospheric CH4 uptake was still difficult to alleviate.

Risk factors for renal outcomes in children with antineutrophil cytoplasmic antibody-associated vasculitis: a nationwide retrospective study in China.

BACKGROUND: Pediatric antineutrophil cytoplasmic antibody-associated vasculitis (AAV) is a life-threatening systemic vasculitis featured by liability to renal involvement. However, there are few studies on the risk factors and predictive models for renal outcomes of AAV in children. METHODS: Data from 179 AAV children in multiple centers between January 2012 and March 2020 were collected retrospectively. The risk factors and predictive model of end-stage renal disease (ESRD) in AAV were explored. RESULTS: Renal involvement was the most typical manifestation (95.5%), and the crescent was the predominant pathological lesion (84.9%). The estimated glomerular filtration rate (eGFR) was evaluated in 114 patients, of whom 59.6% developed ESRD, and the median time to ESRD was 3.20 months. The eGFR [P = 0.006, odds ratio (OR) = 0.955, 95% confidence interval (CI) = 0.924-0.987] and the percentages of global glomerulosclerosis (pGGS; P = 0.018, OR = 1.060, 95% CI = 1.010-1.112) were independent risk factors for ESRD of renal biopsy. Based on the pGGS and eGFR at renal biopsy, we developed three risk grades of ESRD and one predictive model. The Kaplan‒Meier curve indicated that renal outcomes were significantly different in different risk grades (P < 0.001). Compared with serum creatinine at baseline, the predictive model had higher accuracy (0.86 versus 0.58, P < 0.001) and a lower coefficient of variation (0.07 versus 0.92) in external validation. CONCLUSIONS: Renal involvement is the most common manifestation of pediatric AAV in China, of which more than half deteriorates into ESRD. The predictive model based on eGFR at renal biopsy and the pGGS may be stable and accurate in speculating the risk of ESRD in AAV children. Supplementary file 2 (MP4 18937 KB).

Rational design of a booster vaccine against COVID-19 based on antigenic distance.

Current COVID-19 vaccines are highly effective against symptomatic disease, but repeated booster doses using vaccines based on the ancestral strain offer limited additional protection against SARS-CoV-2 variants of concern (VOCs). To address this, we used antigenic distance to in silico select optimized booster vaccine seed strains effective against both current and future VOCs. Our model suggests that a SARS-CoV-1-based booster vaccine has the potential to cover a broader range of VOCs. Candidate vaccines including the spike protein from ancestral SARS-CoV-2, Delta, Omicron (BA.1), SARS-CoV-1, or MERS-CoV were experimentally evaluated in mice following two doses of the BNT162b2 vaccine. The SARS-CoV-1-based booster vaccine outperformed other candidates in terms of neutralizing antibody breadth and duration, as well as protective activity against Omicron (BA.2) challenge. This study suggests a unique strategy for selecting booster vaccines based on antigenic distance, which may be useful in designing future booster vaccines as new SARS-CoV-2 variants emerge.

Transcriptome analysis of multiple tissues reveals the potential mechanism of death under acute heat stress in chicken.

BACKGROUND: Acute heat stress could induce high mortality and cause huge economic losses in the poultry industry. Although many studies have revealed heat stress-induced injuries of multiple tissues, the main target tissue and molecular mechanism of death under acute heat stress was largely unknown. This study systematically compared the transcriptome data of five main visceral tissues in chickens to reveal the response of multiple tissues to acute heat stress and determine the main target tissue of acute heat stress, further revealing the injuries of main target tissue and their potential mechanism by combing pathological section and qRT-PCR technologies. RESULTS: The transcriptome data of five visceral tissues revealed that acute heat stress broadly caused inflammatory response and damaged tissues metabolic homeostasis. Among the five tested visceral tissues, the number of differentially expressed genes in the lung was the highest, and their fold changes were the greatest, indicating that the lung was the main target tissue of acute heat stress. The results of pathological section revealed severe inflammation, emphysema and pulmonary hemorrhage in the lung under acute heat stress. Our study found that some pro-inflammatory genes, including CNTFR, FURIN, CCR6, LIFR and IL20RA, were significantly up-regulated both in the heat-stress and heat-death groups, and their fold changes in the heat-death group were significantly greater than that in the heat-stress group. We also found an anti-inflammatory gene, AvBD9, exhibiting an extremely high expression in the heat-stress group but a low expression in the heat-death group. CONCLUSIONS: Our study found that acute heat stress caused multiple tissue injuries broadly and the lung was the main target tissue of acute heat stress in chicken. Acute heat stress caused a severe inflammatory response, emphysema, and pulmonary haemorrhage, The severe inflammatory response in the heat-death group was related to the up-regulation of pro-inflammatory genes and down-regulation of anti-inflammatory genes.

Robotic-assisted proctosigmoidectomy for Hirschsprung's disease: A multicenter prospective study.

BACKGROUND: Robotic surgery is a cutting-edge minimally invasive technique that overcomes many shortcomings of laparoscopic techniques, yet few studies have evaluated the use of robotic surgery to treat Hirschsprung's disease (HSCR). AIM: To analyze the feasibility and medium-term outcomes of robotic-assisted proctosigmoidectomy (RAPS) with sphincter- and nerve-sparing surgery in HSCR patients. METHODS: From July 2015 to January 2022, 156 rectosigmoid HSCR patients were enrolled in this multicenter prospective study. Their sphincters and nerves were spared by dissecting the rectum completely from the pelvic cavity outside the longitudinal muscle of the rectum and then performing transanal Soave pull-through procedures. Surgical outcomes and continence function were analyzed. RESULTS: No conversions or intraoperative complications occurred. The median age at surgery was 9.50 months, and the length of the removed bowel was 15.50 ± 5.23 cm. The total operation time, console time, and anal traction time were 155.22 ± 16.77, 58.01 ± 7.71, and 45.28 ± 8.15 min. There were 25 complications within 30 d and 48 post-30-d complications. For children aged ≥ 4 years, the bowel function score (BFS) was 17.32 ± 2.63, and 90.91% of patients showed moderate-to-good bowel function. The postoperative fecal continence (POFC) score was 10.95 ± 1.04 at 4 years of age, 11.48 ± 0.72 at 5 years of age, and 11.94 ± 0.81 at 6 years of age, showing a promising annual trend. There were no significant differences in postoperative complications, BFS, and POFC scores related to age at surgery being ≤ 3 mo or > 3 mo. CONCLUSION: RAPS is a safe and effective alternative for treating HSCR in children of all ages; it offers the advantage of further minimizing damage to sphincters and perirectal nerves and thus providing better continence function.