[Clinical features and prognostic factors of advanced myelodysplastic syndromes in children].

Objective: To investigate the clinical features and prognostic factors of advanced myelodysplastic syndromes (MDS) in children. Methods: Clinical data of children diagnosed with advanced MDS in the Hematology & Blood Diseases Hospital, Chinese Academy of Medical Sciences, between September 2009 and April 2022 were retrospectively collected. Follow-up assessments were performed through telephone interviews and the review of medical records until May 1, 2023. The clinical features of children with advanced MDS were summarized by analyzing chromosomal karyotype tests, second-generation gene sequencing results. Multivariate Cox regression analysis was used to investigate the prognostic factors of advanced MDS in children. Results: A total of 69 children, comprising 49 males and 20 females, aged [M (Q1, Q3)] 8 (5, 10) years, were enrolled in the study. Sixty-seven cases underwent chromosomal karyotype testing, of which 42 cases (62.7%) had abnormal karyotypes, with monosomy 7 the most common in 17 cases (25.4%). Forty-three cases underwent next-generation sequencing, with mutations in the SETBP1, NRAS, PTPN11 and RUNX1 genes more common, identified in 12 cases (27.9%), 9 cases (20.9%), 8 cases(18.6%), and 8 cases(18.6%), respectively. The follow-up time [M (Q1, Q3)] was 26 (13, 56) months and the 5-year overall survival rate was 56%(95%CI: 44.4%-70.5%). The 5-year overall survival rate for children who underwent hematopoietic stem cell transplantation (HSCT) was higher than that of children who did not undergo HSCT (73.9% vs 29.1%, P<0.001). HSCT (HR=0.118, 95%CI: 0.037-0.372, P<0.001) was a protective factor for the overall survival rate of children with advanced MDS. Serum ferritin level>356.3 µg/L (HR=6.497, 95%CI: 2.068-20.415, P=0.001) and moderate to severe splenomegaly (HR=4.075, 95%CI: 1.174-14.141, P=0.027) were risk factors for the overall survival rate of children with advanced MDS. Conclusions: Monosomy 7 was the most common abnormal karyotype and SETBP1 was the gene that had the highest mutation frequency in children with advanced MDS. HSCT, increased ferritin and moderate to severe splenomegaly are prognostic factors influencing the overall survival rate of children with advanced MDS.

[Accuracy comparison of total keratometry and standard keratometry in intraocular lens power calculations for post-corneal refractive surgery cataract patients].

Objective: To compare the accuracy of intraocular lens (IOL) power calculations using total keratometry (TK) versus standard keratometry (K) in post-corneal refractive surgery cataract patients. Methods: This retrospective case series study included 30 patients (36 eyes) with a history of laser corneal refractive surgery who underwent cataract extraction and IOL implantation at Qingdao Eye Hospital, Affiliated to Shandong First Medical University, from September 2022 to December 2023. The cohort comprised 16 males and 14 females, with an average age of (53.6±8.1) years. IOL power was calculated using the K-based Haigis-L and Barrett True-K formulas, as well as the TK-based Haigis and Barrett Universal Ⅱ formulas. Postoperative objective refraction was performed to obtain the actual refractive status of the operated eyes. The refractive prediction error (RPE) was defined as the difference between the actual spherical equivalent and the predicted refraction. The absolute value of the RPE was taken as the refractive absolute error (RAE). Differences in errors calculated by the four formulas were compared. Results: TK showed good consistency with K, with TK being on average 0.50 D lower than K. Analysis of variance revealed statistically significant differences in RPE among the four formulas (P<0.001). The RPE for the TK-based Haigis formula was (0.17±0.09) D, and for the Barrett Universal Ⅱ formula, it was (0.21±0.11) D, both significantly better than the K-based Haigis-L formula (-0.61±0.12) D and Barrett True-K formula (-0.57±0.11) D (all P<0.001). The percentage of eyes with postoperative RPE<±1.00 D was higher for the TK-based Haigis (92%, 33 eyes) and Barrett Universal Ⅱ (86%, 31 eyes) formulas compared to the TK-based Barrett True-K (75%, 27 eyes) and Haigis-L formulas (67%, 24 eyes), with statistically significant differences (P<0.05). Conclusions: Compared with K, TK improves the accuracy of IOL power calculation in post-corneal refractive surgery patients. Both the TK-based Barrett Universal Ⅱ and Haigis formulas demonstrate high accuracy.

[Association of urinary cadmium levels with peripheral leukocyte classification counts among middle-aged and older adults aged 40-89 in selected areas of China].

Objective: To investigate the association of urinary cadmium levels with peripheral leukocyte classification counts among middle-aged and older adults aged 40 to 89 years in selected areas of China. Methods: The research was based on the survey of the impact of soil quality of agricultural land on human health in typical areas conducted in 2019-2020. A total of 5 600 middle-aged and older adults aged 40 to 89 years were included by using a multi-stage stratified random sampling method. Baseline characteristics of the subjects were collected and physical examinations were performed. Random midstream urine was collected to measure urinary cadmium and urinary creatinine and fasting venous blood was collected to measure the leukocyte count, neutrophil count, lymphocyte count, monocyte count and eosinophil count. The linear mixed effect model was used to analyse the association of urinary cadmium levels with leukocyte classification counts, and the dose-response relationship between them was analyzed by using the restricted cubic spline (RCS) function. Results: The age of the subjects was (63.17±12.02) years; 2 851 (50.91%) were males; and the M (Q1, Q3) of urinary creatinine-corrected urinary cadmium levels was 2.69 (1.52, 4.69) µg/g·creatinine. After adjusting for confounding factors, the results of linear mixed effects model analysis showed that for each 1-unit increase in urinary creatinine-corrected urinary cadmium level, the percentage change [% (95%CI)] of leukocyte count and lymphocyte count was -1.70% (-2.61%, -0.79%) and -1.57% (-2.86%, -0.26%), respectively. RCS function showed a negative linear relationship between urinary creatinine-corrected urinary cadmium levels and leukocyte counts and lymphocyte counts, respectively (all Pnon-linear>0.05). Conclusion: Urinary cadmium levels are negatively associated with leukocyte count and lymphocyte count among middle-aged and older adults aged 40 to 89 years in selected areas of China.

[Research progress on the effects of exposure to major persistent organic pollutants during pregnancy on the functional development of nervous system in children].

Persistent Organic Pollutants (POPs) have the characteristics of resistance to environmental degradation, bioaccumulation and long-distance migration potential. Maternal exposure to POPs during pregnancy can enter the fetal blood circulation through the placental barrier, and have a potential impact on the functional development of the nervous system of the offspring. This in turn leads to the occurrence and development of neurological defects and diseases in adulthood. The purpose of this paper is to elucidate the effects of exposure to three major POPs (organochlorine compounds, perfluoroalkyl and polyfluoroalkyl substances, and polybrominated diphenyl ethers) during pregnancy on the functional development of the nervous system (social emotions, cognition, language, exercise, and adaptability) in children, and to provide reference for subsequent studies.

[Analysis of efficacy and prognosis of allogeneic hematopoietic stem cell transplantation for the treatment of combined immunodeficiency].

Objective: To evaluate the efficacy of allogeneic hematopoietic stem cell transplantation for the treatment of combined immunodeficiency (CID) and explore prognostic risk factors. Methods: In this retrospective cohort study, clinical characteristics, laboratory tests and prognosis of 73 CID children who underwent allogeneic hematopoietic stem cell transplantation from February 2014 to April 2022 in the Children's Hospital of Fudan University were analyzed. Based on the subtypes of diseases, all patients were divided into severe combined immunodeficiency disease (SCID) group and other CID group. Based on the types of donors, all patients were divided into matched sibling donor group, matched unrelated donor group, unrelated cord blood group, and haploidentical donor group. Kaplan-Meier method and Log-Rank test were used to analyze the survival data. Cox regression was used to analyze prognostic factors. Results: Among the 73 patients, there were 61 (84%) males and 12 (16%) females. Fifty-five (75%) patients were SCID, and 18 (25%) patients were other CID. Donor source included 2 (3%) matched sibling donors (MSD), 3 (4%) matched unrelated donors (MUD), 64 (88%) unrelated cord blood (UCB), and 4 (5%) haploidentical donors. The age at transplant was 10.7 (5.9, 27.5) months, and the follow-up time was 36.2 (2.5, 62.9) months. The 3-year overall survival rate of 73 patients with CID was (67±6) %. No significant difference was found in the 3-year overall survival rates between patients with SCID (55 cases) and other CID (18 cases) ((64±7) % vs. (78±10) %, χ2=1.31, P=0.252). And no significant difference was found in the 3-year overall survival rates among patients who received MSD or MUD (5 cases), UCB (64 cases), and haploidentical donor (4 cases) transplant (100% vs. (66±6)% vs. (50±25) %, χ2=2.30, P=0.317). Cox regression analysis showed that the medical history of sepsis (HR=2.55, 95%CI 1.05-6.20, P=0.039) and hypoalbuminemia at transplant (HR=2.96, 95%CI 1.14-7.68, P=0.026) were independent risk factors for the prognosis of allogeneic hematopoietic stem cell transplantation in pediatric patients with CID. Conclusions: Allogeneic hematopoietic stem cell transplantation is an effective treatment for CID. The medical history of sepsis and hypoalbuminemia at transplant were risk factors for prognosis. Enhancing infection prevention and nutritional intervention before transplant can improve patient prognosis.

Fe3O4nanoparticles anchored on carbon nanotubes as high-performance anodes for asymmetric supercapacitors.

Fe3O4/CNT composites are synthesized with ethylene glycol as solvent by a one-step solvothermal method and used as anode materials for asymmetric supercapacitors (ASC). An appropriate amount of water in ethylene glycol can accelerate the formation of Fe3O4and reduce the average size of Fe3O4to around 20 nm. However, spherical Fe3O4particles larger than 100 nm will form in pure ethylene glycol for long reaction time. The Fe3O4/CNT composite with small Fe3O4nanoparticles exhibits a high specific surface area, promoted electron transfer ability, as well as a high utilization rate of active materials. The optimized electrode shows a high specific capacity of 689 C g-1at 1 A g-1, and remains 443 C g-1at 10 A g-1. The inferior long-term cycling stability is due to the phase transition of Fe3O4and a reductive effect to form metallic Fe. An ASC using Fe3O4/CNT and NiCoO2/C composites as anode and cathode, respectively, delivers a high energy density of 58.1 Wh kg-1at a power density of 1007 W kg-1in a voltage window of 1.67 V and has a capacity retention of 63% after 5000 cycles. The self-discharge behavior of the ASC is also investigated.

Effects of different light-emitting diode light on hatch performance, embryo development, eye structure, and plasma melatonin in layer incubation.

Light intensity, wavelength, and photoperiod have a combined effect on chicken incubation. This study was conducted to evaluate the effect of 12-h light, 12-h dark (12L:12D) photoperiod of white light (380-780 nm, WL), blue light (455/447.5-462.5 nm, BL), and green light (525/515-535 nm, GL) in chicken perceived light intensity during layer incubation on hatching performance, embryo development, eye structure, and melatonin concentration. Three batches of eggs from Jinghong No. 1 layer breeder were used in this experiment. Light stimulation had no effect on hatchability, and no consistent effect on embryo weight and newly hatched chick weight. However, the average hatching time of white light group and green light group was 7.3 h and 5.5 h later than that of the control group. Therefore, the holding period of chicks was significantly shortened (P = 0.001) in these 2 light groups. Light stimulation had a significant effect on the thickness of retinal layers (P < 0.05), retinal layers of white light group was thicker than that of the other 3 groups. Melatonin levels of chicks hatched in the green light and blue light were significantly higher than that of chicks hatched in the white light and darkness (P < 0.05). It indicated that the monochrome green and blue light promoted the expression of melatonin in chicken embryos. No significant diurnal rhythms were found at the level of plasma melatonin in 4 groups on d 21 using cosine analysis. It was concluded that green light has a positive effect on embryo development and melatonin secretion, while white light probably has positive effect on eye development. Furthermore, both green and white light stimulation resulted in late hatch for layer egg incubation. The obtained results are important in determining the light protocol for chicken incubation.

[Detection of small airway dysfunction in bronchial asthma and its clinical application].

Bronchial asthma is a common chronic inflammatory airway disease. Small airway dysfunction (SAD) can be present in asthmatics with different phenotypes, clinical stages and varied severity, and has implication for drug efficacy and patient prognosis. Currently, there is no consensus on the criteria for SAD, and its inflammatory mechanism remains unclear. In this paper, we reviewed the research advances in the evaluation, prevalence, pathogenesis, clinical features and treatment of SAD in asthmatics to improve awareness of the disease.

[Constructing the Bayesian network models to explore the factors related to glomerular and tubular injury].

Objective: To construct Bayesian network (BN) models to explore the factors related to glomerular injury (GI) and tubular injury (TI). Methods: A cross-sectional study was carried out. From April to November 2019, Shanxi Provincial People's Hospital performed an opportunistic screening for chronic kidney disease in 10 counties of Shanxi Province. The general data and laboratory results of blood and urine samples were collected. Chi-square test and logistic regression were used to explore the related factors of GI and TI, which were included in the construction of BN models with max-min hill-climbing (MMHC) algorithm. Results: A total of 12 269 participants were included, there were 5 198 males and 7 071 females, with a median age of 58 (40-91) years. The prevalence of GI and TI was 12.7% (1 561/12 269) and 11.6% (1 425/12 269), respectively. The BN model consisted of 8 nodes and 10 edges for GI, and 11 nodes and 17 edges for TI, respectively. BN models showed that age and glycated hemoglobin were direct related factors for GI, while gender and fasting blood glucose were indirect related factors for GI. Age, gender, fasting blood glucose and glycosylated hemoglobin were direct related factors for TI. Additionally, the area under the receiver operating characteristic curve (AUC) was 0.761 (95%CI: 0.746-0.777) and 0.753 (95%CI: 0.736-0.769) for GI and TI BN models, respectively. Conclusions: BN models allow for identifying the complex network relationships among the factors related to GI and TI. Meanwhile, Bayesian risk reasoning can provide reference value for the clinical prevention of GI and TI.

Controllable reduction of NiCoO2@NiCo core-shell nanospheres on CNTs for high-performance electrochemical energy storage.

The performances of energy storage devices are strongly dependent on the electrode materials. Owing to the high theoretical capacity, NiCoO2 is a promising transition metal oxide for supercapacitors. Despite many efforts have been devoted, it still lacks of effective methods to overcome its shortcomings such as low conductivity and poor stability, in order to achieve its theoretical capacity. Herein, utilizing the thermal reducibility of trisodium citrate and its hydrolyzate, a series of NiCoO2@NiCo/CNT ternary composites in which NiCoO2@NiCo core-shell nanospheres deposited on CNT surface with adjustable metal contents are synthesized. Benefiting from the enhanced synergistic effect of both metallic core and CNTs, the optimized composite exhibits an extremely high specific capacitance (2660 F g-1 at 1 A g-1, the effective specific capacitance of the loaded metal oxide is 4199 F g-1, close to the theoretical value), an excellent rate performance and stability, when the metal content is about 37%. After depolarized calculation, the energy storage mechanism of the composite is reasonably analyzed. By controlling the contents of hexamethylenetetramine, trisodium citrate and CNTs in the reactant, the roles of them are distinguished. This study reveals an efficient novel strategy for transition metal oxides to maximize the electrochemical performances.

[External rhinoplasty based on the classification of alar retraction associating with exposure of the nostrils].

Objective: To introduce a classification of alar retraction, and to discuss the therapeutic strategy of alar retraction with cartilage graft and the satisfaction evaluation of patients after operation. Methods: A retrospective analysis was performed on 88 patients with alar retraction admitted to the Department of Plastic and Aesthetic (Burn) Surgery, the Second Xiangya Hospital of Central South University from January 2015 to December 2020, including 20 males and 68 females, aged 20 to 48 years, with an average age of 28.98 years. All patients underwent external rhinoplasty according to a series of treatment plans determined by the classification of alar retraction based on nostril exposure. Visual Analogue Scale (VAS) and Rhinoplasty Outcomes Evaluation (ROE) were used to conduct satisfaction survey before and 12 months after operation. Wilcoxon signed-rank test was used to analyze patient satisfaction. Results: A total of 88 patients were included in this study. According to the classification of alar retraction based on nostril exposure, 45 cases were mild, 23 cases were moderate, and 20 cases were severe. There were 16 cases of unilateral and 72 cases of bilateral alar retraction. The patients were followed up for 12 to 18 months, with an average of 13.37 months. The VAS score and ROE score after each type of surgery were higher than those before surgery, with statistically significant (all P<0.05). Among them, the difference in VAS score (6.75±1.29) and in ROE satisfaction (67.70±7.38) of patients with severe alar retraction were the most significant improvement. Conclusion: The classification of alar retraction based on nostril exposure in the frontal view can comprehensively evaluate the severity of alar retraction, and makes the treatment algorithms systematic and comprehensive. The satisfaction of patients is relatively high.

A new paradigm of sewage collection in rural areas.

Rural sewage collection networks play extremely important roles in rural sewage treatment, and the lack of a suitable collection model makes this task difficult. Hence, there is an urgent need to develop a new method to collect and deal with rural sewage. This paper establishes a rural sewage optimal collection model (RSOCM) with critical distance (d) and sewage quota per unit area (qs) as the constraint factors. The implementation of critical distance for rural sewage collection pipeline networks was demonstrated for 38 rural areas in the Huicheng District, Huizhou City, Guangdong Province of China. The average critical distances of 22 m, 38 m, 29 m, 29 m, 41 m, and 55 m were demonstrated for Sandong Town, Ma'an Town, Luzhou Town, Ruhu Town, Hengli Town, and Shuikou Subdistrict, respectively. The qs is used to create the best possible pipe network layout, determine the appropriate treatment method, and reduce construction costs. This model can be widely applied to sewage collection in rural areas of China, where the overall sewage collection system can implement different regional strategies to maximize rural pollution control and protect the environment.

Clinical value of combining serum tumor marker detection with fecal occult blood testing in diagnosing colorectal cancer.

This study aimed to investigate the value of combining the detection of serum tumor markers, namely, carcinoembryonic antigen (CEA), carbohydrate antigen (CA) 199, CA 242, and CA 50, with fecal occult blood (FOB) testing in the diagnosis of colorectal cancer (CRC). One hundred patients with CRC who were diagnosed and treated at the First Hospital of Jiaxing, Zhejiang Province, China, between January 2019 and April 2020 were enrolled as the case group, and 200 healthy people who underwent a physical examination at the hospital during the same period were recruited as the control group. The concentrations of CEA, CA199, CA242, and CA50 in serum were measured alongside FOB indicators. Compared with the control group, the concentrations of CEA, CA199, CA242, and CA50 in the case group were significantly higher, and they were related to age, tumor differentiation, tumor stage, and other clinicopathological features (P<0.05). The diagnostic performance of the combination of four tumor markers for CRC was significantly better than when using a single marker (four-combined test: AUC (area under the curve) AUC=0.80), and the diagnostic performance was further improved after adding the fecal occult blood test test (FOBT) results (five-combined test: AUC=0.90). The combined detection of the five indexes was found to be effective for the early diagnosis of CRC (AUC=0.87). We concluded that the detection of serum tumor markers CEA, CA199, CA242, and CA50 combined with an FOBT could significantly improve the sensitivity and accuracy of a CRC diagnosis and contributed to an early diagnosis and appropriate treatment.

[Epidemiological characteristics and Spatial-temporal clustering of hand, foot and mouth disease in Shanxi province, 2009-2020].

Objective: To analyze the epidemiology and spatial-temporal distribution characteristics of hand, foot and mouth disease (HFMD) in Shanxi province. Methods: The data of HFMD in Shanxi province from 2009 to 2020 were collected from notifiable disease management information system of Chinese information system for disease control and prevention and analyzed by descriptive epidemiology, Joinpoint regression, spatial autocorrelation analysis and spatio- temporal scanning analysis. Results: A total of 293 477 HFMD cases were reported in Shanxi province from 2009 to 2020, with an average annual incidence of 67.64/100 000 (293 477/433 867 454), severe disease rate of 5.36/100 000 (2 326/433 867 454), severe disease ratio of 0.79%(2 326/293 477), mortality of 0.015/100 000 (66/433 867 454), and fatality rate of 22.49/100 000 (66/293 477). The reported incidence rate, severe disease rate, mortality rate and fatality rate of HFMD showed decreasing trends. The main high-risk groups were scattered children and kindergarten children aged 0-5. The incidence of HFMD had obvious seasonal variation, with two peaks every year: the main peak was during June-July, the secondary peak was during September-October and the peak period is from April to November. A total of 13 942 laboratory cases were confirmed, with a diagnosis rate of 4.75% (13 942/293 477), including 4 438 (35.11%, 4 438/293 477) Enterovirus A71 (EV-A71) positive cases, 4 609 (33.06%, 4 609/293 477) Coxsackievirus A16 (CV-A16) positive cases, and 4 895 (31.83%, 4 895/293 477) other enterovirus positive cases. There was a spatial positive correlation (Moran's I ranged from 0.12 to 0.58, all P<0.05) and the spatial clustering was obvious. High-risk regions were mainly distributed in Taiyuan in central Shanxi province, Linfen and Yuncheng in southern Shanxi province, and Changzhi in southeastern Shanxi province. Spatial-temporal scanning analysis revealed 1 the most likely cluster and 8 secondary likely clusters, of which the most likely cluster (RR=2.65, LLR=22 387.42, P<0.001) located in Taiyuan and Jinzhong city, Shanxi province, including 12 counties (districts), and accumulated from April 1, 2009 to November 30, 2018. Conclusions: There was obvious spatial-temporal clustering of HFMD in Shanxi province, and the epidemic situation was in decline. The key areas were the districts in urban areas and the counties adjacent to it. Meanwhile, the monitoring and classification of other enterovirus types of HFMD should be strengthened.

[The influence of meteorological factors on SARS-CoV-2 transmission: evidence from laboratory and epidemiological studies].

SARS-CoV-2 has infected more than 600 million people worldwide and caused more than 6 million deaths. The emerging novel variants have made the epidemic rebound in many places. Meteorological factors can affect the epidemic spread by changing virus activity, transmission dynamic parameters and host susceptibility. This paper systematically analyzed the currently available laboratory and epidemiological studies on the association between the meteorological factors and COVID-19 incidence, in order to provide scientific evidence for future epidemic control and prevention, as well as developing early warning system.

[Analysis of risk factors and prognosis of cytomegalovirus infection post umbilical cord blood stem cell transplantation in children with primary immunodeficiency diseases].

Objective: To investigate the risk factors and outcomes of cytomegalovirus (CMV) infection post umbilical cord blood stem cell transplantation (UCBT) in children with primary immunodeficiency diseases (PID). Methods: Clinical data of 143 PID children who received UCBT in the Children's Hospital of Fudan University from January 2015 to June 2020 were collected retrospectively. CMV-DNA in the plasma was surveilled once or twice a week within 100 days post-UCBT. According to the CMV-DNA test results, children were divided into the CMV-infected group and the CMV-uninfected group. The incidence and risk factors of CMV infection were analyzed. At 1-month post-UCBT, the absolute lymphocyte count, ratio of lymphocyte subsets and immunoglobulin levels were compared between those whose CMV infection developed 1-month later post-UCBT and those not. Mann-Whitney U test and chi-squared test were used for comparision between groups. Kaplan-Meier survival analysis was used to analyze the impact of CMV infection on survival. Results: Among 143 patients, there were 113 males and 30 females, with a age of 14 (8, 27) months at UCBT. Chronic granulomatosis disease (n=49), very-early-onset inflammatory bowel disease (n=43) and severe combined immunodefiency (n=29) were the three main kinds of PID. The rate of CMV infection was 21.7% (31/143), and the time of infection occurring was 44 (31, 49) days post-UCBT. The incidence of recurrent CMV infection was 4.2% (6/143) and refractory CMV infection was 4.9% (7/143).There was no significant difference in the first time CMV-DNA copy and peak CMV-DNA copy during treatment between the recurrent CMV infection group and the non-recurrent CMV infection group (32.8 (18.3, 63.1)×106 vs. 22.5 (13.2, 31.9)×106 copies/L, Z=-0.95, P=0.340;35.2 (20.2, 54.6)×106 vs. 28.4 (24.1, 53.5)×106copies/L, Z=-0.10, P=0.920), so were those between the refractory CMV infection group and non-refractory CMV infection group (21.8 (13.1, 32.2)×106 vs. 25.9 (14.2, 12.2)×106copies/L, Z=-1.04, P=0.299; 47.7 (27.9, 77.6)×106 vs. 27.7 (19.7,51.8)×106copies/L, Z=-1.49, P=0.137). The CMV-infected group accepted more reduced-intensity conditioning (RIC) regimen than the CMV-uninfected group (45.2% (14/31) vs. 25.0% (28/112), χ2=4.76, P<0.05). The rate of CMV-seropositive recipients and Ⅱ-Ⅳ acute graft versus host diseases (aGVHD) are significantly higher in the CMV-infected group than the CMV-uninfected group (100% (31/31) vs. 78.6% (88/112), 64.5% (20/31) vs. 26.8% (30/112), χ2=7.98,15.20, both P<0.05). The follow-up time was 31.6 (13.2, 45.9) months, CMV infection had no effect on overall survival (OS) rate (χ2=0.02, P=0.843). There was significant difference in the survival rate among three groups of refractory CMV infection, non-refractory CMV infection and the CMV-uninfected (4/7 vs.95.8% (23/24) vs. 86.6% (97/112), χ2=5.91, P=0.037), while there was no significant difference in the survival rate among three groups of recurrent CMV infection, non-recurrent CMV infection and the CMV-uninfected (5/6 vs. 88.0% (22/25) vs. 86.6% (97/112), χ2=0.43, P=0.896). Children who developed CMV infection after 30 days post-UCBT had lower absolute count and rate of CD4+ T cells and immunoglobulin G (IgG) level than those in the CMV-uninfected group (124.1 (81.5, 167.6) ×106 vs. 175.5 (108.3, 257.2) ×106/L, 0.240 (0.164, 0.404) vs. 0.376 (0.222, 0.469), 9.3 (6.2, 14.7) vs. 13.6 (10.7, 16.4) g/L, Z=-2.48, -2.12,-2.47, all P<0.05), but have higher rate of CD8+T cells than those in CMV-uninfected group (0.418 (0.281, 0.624) vs. 0.249 (0.154, 0.434), Z=-2.56, P=0.010). Conclusions: RIC regimen, grade Ⅱ-Ⅳ aGVHD and CMV-seropositive recipients are the main risk factors associated with CMV infection in PID patients post-UCBT. Survival rate of children with refractory CMV infection after UCBT is reduced. Immune reconstitution in children after UCBT should be regularly monitored, and frequency of CMV-DNA monitoring should be increased for children with delayed immune reconstitution.

[The feasibility study of objective evaluation of the severity of motion sickness by quantitative analysis of the facial skin color].

Objective: To explore the feasibility of applying quantitative analysis of the facial skin color to evaluate the severity of motion sickness objectively and to seek objective indicators that can reflect the severity of motion sickness. Methods: Motion sickness was induced in 51 male adult subjects recruited at the Air Force Medical University by Coriolis acceleration stimulation, and facial skin colorimetric values were acquired using a portable spectrophotometer at five time points: before stimulation and at 0 min, 10 min, 20 min and 30 min after the end of stimulation. The Graybiel rating scales were applied to assess the severity of motion sickness in subjects at each time point after stimulation, and the correlation between the magnitude of change in each colorimetric value and the maximum Graybiel's score was analyzed. The ROC curves were used to compare the evaluation performance of colorimetric value indicators which could reflect the severity of motion sickness. Results: Each colorimetric value in the CIE-L*a*b* color system changed significantly after exposure to provocative motion stimuli, and the trend was consistent with the typical sign of pallor in motion sickness. The magnitudes of the increase in the colorimetric value CIE-L*, the decrease in CIE-a*, and the increase in CIE-b* were all significantly and positively correlated with the maximum of Graybiel's scores (r=0.490 0, P=0.000 3; r=0.549 3, P<0.000 1; r=0.540 9, P<0.000 1). Comparing the performance of three colorimetric indicators to assess the severity of motion sickness, CIE-a* had an area under the ROC curve of 0.875 0, a sensitivity of 85.71%, and a specificity of 87.50%, which was better than CIE-L* and CIE-b*. Conclusions: The CIE-L*a*b* colorimeter values can be considered as objective indicators of the severity of motion sickness, among which the colorimetric indicator CIE-a* has the most diagnostic significance, and the method of quantitative analysis of the facial skin color can provide a new reference for the objective evaluation of the severity of motion sickness.

Monitoring mild cognitive impairment of workers exposed to occupational aluminium based on quantitative susceptibility mapping.

AIM: To investigate the diagnostic value of quantitative susceptibility mapping (QSM) in mild cognitive impairment (MCI) of aluminium (Al) workers. MATERIALS AND METHODS: The basic data of 53 workers in an Al factory were collected and divided into the MCI group and normal control (NC) group by Montreal Cognitive Assessment (MoCA) scores. All participants were tested for plasma Al concentration and had magnetic resonance imaging (MRI). The QSM values of many areas of the brain were delineated and measured. Independent two-sample t-tests or non-parametric tests were used to compare the parameter values between the two groups. Spearman's correlation analysis was performed between QSM values, MoCA scores, and plasma Al concentration. The receiver operating characteristic curve and z test were performed to assess diagnostic efficacy and the best parameter. RESULTS: There was no difference in age and educational level. Plasma Al concentration of the MCI group was higher than that of NC group (p=0.057). QSM values of the left hippocampus, left dentate nucleus, right substantia nigra, and left putamen in MCI group were higher than that of NC group (p<0.05), and the left hippocampus had the best diagnostic efficacy. QSM values correlated negatively with MoCA scores. No correlation was found between QSM values and plasma Al concentration (p>0.05). CONCLUSION: QSM might be a neuroimaging marker for the diagnosis of MCI. The left hippocampus showed the best diagnostic efficacy. Plasma Al concentration of the MCI group was higher than that of the NC group. A correlation between QSM and plasma Al concentration was not found.

A novel multi-objective optimization framework for urban green-gray infrastructure implementation under impacts of climate change.

Frequent urban flooding disasters can cause severe economic and property losses. Accordingly, the construction of sponge city has become critical to alleviating urban flooding. However, the functional and structural integration of Green Infrastructure (GI) and Gray Drainage Facility (GDF) is still a matter of concern. This study proposed a novel implementation framework for GI and GDF synchronization optimization (G-GSOIF) based on the SWMM and SUSTAIN models, and used data from Beilin District in Xi'an, China to verify the effects. The results show that the spatiotemporal integrated optimization design of GI and GDF proves to be effective in stormwater management. The total investment was reduced by 16.7% and economic benefit was increased by 15.4% based on disaster risk control, and the utilization rate of rainwater resources exceeded 40%. The Staged optimization model (SSOM) based on the SUSTAIN model established in the G-GSOIF was demonstrated to effectively cope with the impact of future climate change by adjusting and optimizing the design scheme dynamically in different simulation scenarios. Integrated LID (I-LID) measures are conducive for simulation of large catchment areas, and have the same implementation effect as distributed LID measures. The results of this study could support decision-making for urban stormwater management and sponge city construction.