Etomidate-induced hypokalemia in electronic cigarette users: two case reports and literature review.

Hypokalemia is a common clinical condition that can lead to muscle weakness, difficulty breathing, malignant arrhythmias, and even death. This report describes two cases of severe hypokalemia resulting from the use of electronic cigarettes containing etomidate, both accompanied by varying degrees of adrenal hyperplasia. In both cases, the patients were admitted to the hospital with lower limb weakness and difficulty walking. Relevant examinations revealed low blood potassium, low cortisol, high adrenocorticotropic hormone, low renin, and low aldosterone levels in the patients, with Case 2 also having significant hypertension. In both cases, adrenal CT scans showed thickening of the adrenal glands. After the delivery of potassium supplementation in both cases, blood potassium levels gradually returned to normal and muscle strength gradually improved. The case reports are followed by a review of the literature on etomidate and its related mechanisms of action with discussion of its association with hypokalemia.

Nutrient enrichment, propagule pressure, and herbivory interactively influence the competitive ability of an invasive alien macrophyte Myriophyllum aquaticum.

Introduction: Freshwater ecosystems are susceptible to invasion by alien macrophytes due to their connectivity and various plant dispersal vectors. These ecosystems often experience anthropogenic nutrient enrichment, favouring invasive species that efficiently exploit these resources. Propagule pressure (reflecting the quantity of introduced individuals) and habitat invasibility are key determinants of invasion success. Moreover, the enemy release hypothesis predicts that escape from natural enemies, such as herbivores, allows alien species to invest more resources to growth and reproduction rather than defense, enhancing their invasive potential. Yet, the combined impact of propagule pressure, herbivory, and nutrient enrichment on the competitive dynamics between invasive alien macrophytes and native macrophyte communities is not well understood due to a paucity of studies. Methods: We conducted a full factorial mesocosm experiment to explore the individual and combined effects of herbivory, nutrient levels, propagule pressure, and competition on the invasion success of the alien macrophyte Myriophyllum aquaticum into a native macrophyte community comprising Vallisneria natans, Hydrilla verticillata, and Myriophyllum spicatum. This setup included varying M. aquaticum densities (low vs. high, simulating low and high propagule pressures), two levels of herbivory by the native snail Lymnaea stagnalis (herbivory vs no-herbivory), and two nutrient conditions (low vs. high). Myriophyllum aquaticum was also grown separately at both densities without competition from native macrophytes. Results: The invasive alien macrophyte M. aquaticum produced the highest shoot and total biomass when simultaneously subjected to conditions of high-density intraspecific competition, no herbivory, and low-nutrient availability treatments. Moreover, a high propagule pressure of M. aquaticum significantly reduced the growth of the native macrophyte community in nutrient-rich conditions, but this effect was not observed in nutrient-poor conditions. Discussion: These findings indicate that M. aquaticum has adaptive traits enabling it to flourish in the absence of herbivory (supporting the enemy release hypothesis) and in challenging environments such as intense intraspecific competition and low nutrient availability. Additionally, the findings demonstrate that when present in large numbers, M. aquaticum can significantly inhibit the growth of native macrophyte communities, particularly in nutrient-rich environments. Consequently, reducing the propagule pressure of M. aquaticum could help control its spread and mitigate its ecological impact. Overall, these findings emphasize that the growth and impacts of invasive alien plants can vary across different habitat conditions and is shaped by the interplay of biotic and abiotic factors.

A morphology-based integrated teaching mode combining pathology and radiology with the aid of teaching media: A randomized controlled trial.

OBJECTIVE: The integration of curriculum is an important approach for enhancing medical education and facilitating interdisciplinary connections among students. This study aimed to develop a new morphological integrated teaching mode for undergraduate stomatology education by combining stomatological pathology and radiology courses with instructional media. METHODS: In total, 63 undergraduates were included in this study and divided into three groups: traditional (Group T; the control group) and two experimental groups: KoPa WiFi EDU (Group K), and KoPa WiFi EDU-cone beam computed tomography (CBCT) (Group K-C). All participants attended a 2-h lecture on periapical cysts and completed the first theoretical test. Subsequently, they underwent a 4-h experimental training session on the pathology and radiology of periapical cysts using different teaching methods. Following the training, participants completed the second theoretical test and underwent the first image-reading skill evaluation. After a 3-month period, participants completed the third theoretical test and underwent the second image-reading skill evaluation. The effectiveness of the teaching methods was assessed by analyzing the differences in theoretical test and experimental skill evaluation scores. RESULTS: There were no significant differences in the first theoretical outcomes among three groups (p > 0.05). However, the second theoretical scores, the first objective evaluation scores, and the first subjective evaluation scores were significantly higher in the integrated teaching mode (3D teaching mode with the KoPa WiFi EDU and CBCT: 89.29 ± 4.55, 81.00 ± 8.15, and 61.57 ± 5.52, respectively; 2D teaching mode with the KoPa WiFi EDU system: 80.43 ± 3.41, 73.00 ± 8.01, and 55.67 ± 5.66, respectively) than in the traditional teaching mode (72.57 ± 3.84, 69.38 ± 4.91, and 48.67 ± 5.54, respectively) (p < 0.05). Moreover, the long-term teaching effect of the integrated mode was better than that of the traditional mode (p < 0.05). CONCLUSIONS: The morphology-based integrated teaching mode combining pathology and radiology aroused student enthusiasm for learning, and resulted in enhanced learning outcomes in dental experimental education.

Predictive value of angiopoietin-like protein 8 in metabolic dysfunction-associated fatty liver disease and its progression: A case-control study.

BACKGROUND: The prevalence of metabolic dysfunction-associated fatty liver disease (MAFLD) is rapidly increasing, currently affecting approximately 25% of the global population. Liver fibrosis represents a crucial stage in the development of MAFLD, with advanced liver fibrosis elevating the risks of cirrhosis and hepatocellular carcinoma. Simple serum markers are less effective in diagnosing liver fibrosis compared to more complex markers. However, imaging techniques like transient elastography face limitations in clinical application due to equipment and technical constraints. Consequently, it is imperative to identify a straightforward yet effective method for assessing MAFLD-associated liver fibrosis. AIM: To investigate the predictive value of angiopoietin-like protein 8 (ANGPTL8) in MAFLD and its progression. METHODS: We analyzed 160 patients who underwent abdominal ultrasonography in the Endocrinology Department, Xiaogan Central Hospital affiliated to Wuhan University of Science and Technology, during September 2021-July 2022. Using abdominal ultrasonography and MAFLD diagnostic criteria, among the 160 patients, 80 patients (50%) were diagnosed with MAFLD. The MAFLD group was divided into the liver fibrosis group (n = 23) and non-liver fibrosis group (n = 57) by using a cut-off fibrosis-4 index ≥ 1.45. Logistical regression was used to analyze the risk of MAFLD and the risk factors for its progression. Receiver operating characteristic curves were used to evaluate the predictive value of serum ANGPTL8 in MAFLD and its progression. RESULTS: Compared with non-MAFLD patients, MAFLD patients had higher serum ANGPTL8 and triglyceride-glucose (TyG) index (both P < 0.05). Serum ANGPTL8 (r = 0.576, P < 0.001) and TyG index (r = 0.473, P < 0.001) were positively correlated with MAFLD. Serum ANGPTL8 was a risk factor for MAFLD [odds ratio (OR): 1.123, 95% confidence interval (CI): 1.066-1.184, P < 0.001). Serum ANGPTL8 and ANGPTL8 + TyG index predicted MAFLD [area under the curve (AUC): 0.832 and 0.886, respectively; both P < 0.05]. Compared with MAFLD patients without fibrosis, those with fibrosis had higher serum ANGPTL8 and TyG index (both P < 0.05), and both parameters were positively correlated with MAFLD-associated fibrosis. Elevated serum ANGPTL8 (OR: 1.093, 95%CI: 1.044-1.144, P < 0.001) and TyG index (OR: 2.383, 95%CI: 1.199-4.736, P < 0.013) were risk factors for MAFLD-associated fibrosis. Serum ANGPTL8 and ANGPTL8 + TyG index predicted MAFLD-associated fibrosis (AUC: 0.812 and 0.835, respectively; both P < 0.05). CONCLUSION: The serum levels of ANGPTL8 are elevated and positively correlated with MAFLD. They can serve as predictors for the risk of MAFLD and liver fibrosis, with the ANGPTL8 + TyG index potentially exhibiting even higher predictive value.

Concentration quenching inhibition and fluorescence enhancement in Eu3+-doped molybdate red phosphors with two-phase mixing.

Red phosphor plays a crucial role in improving the quality of white light illumination and backlight displays. However, significant challenges remain to enhance red emission intensity in different matrix materials. Herein, a class of two-phase mixing red phosphors of NaIn1-x(MoO4)2:xEu3+ (NIMO:xEu3+) has been successfully prepared by the traditional high-temperature solid-state reaction method. The coordination environment, phase structure, excitation and emission spectra, fluorescence kinetics, and temperature-dependent luminescence properties of the system have been studied comprehensively. It is worth mentioning that the red emission intensity continues to increase with the increased Eu3+ doping concentration, and the fluorescence lifetimes remain unchanged. These extraordinary phenomena mainly stem from the special concentration quenching mechanism in such two-phase mixing material, namely, the increased lattice interface barriers from Eu six-coordinated units and Eu eight-coordinated units can effectively block the non-radiation by enlarging the average distance between luminescent centers. The improved fluorescence thermal stability and suppressed non-radiative transition rate in NIMO:40%Eu3+ sample are further proving regulatory role of lattice interface barriers. In addition, a warm white light-emitting diode (LED) is successfully fabricated, exhibiting Commission Internationale de l'Eclairage (CIE) coordinates of (0.343, 0.335), a color rendering index (CRI) of 92.1, and a correlated color temperature (CCT) of 5013 K, showing significant application prospects for high-quality lighting devices.

A review on nondiabetic hypoglycemia from various causes: Case series report.

RATIONALE: Hypoglycemia is common in patients with glucose regulation disorders and related diabetic treatments but is rare in nondiabetic patients. Severe hypoglycemia can cause harm to patients' cognition, consciousness, central nervous system, cardiovascular and cerebrovascular system, and even death. However, the most fundamental way to control hypoglycemia is to identify the cause and deal with the primary disease. This article introduces 3 cases of nondiabetic hypoglycemia with different causes, aiming to improve our understanding of nondiabetic hypoglycemia and improve the ability of early diagnosis and differential diagnosis. PATIENT CONCERNS: Case 1 is a 19-year-old female with a history of recurrent coma, and magnetic resonance imaging and endoscopic ultrasound of the pancreas suggest insulinoma. Case 2 is a 74-year-old male with a history of viral hepatitis, and computerized tomography shows multiple nodules in the liver, which is diagnosed as liver cancer. Case 3 is a 39-year-old female with a history of taking methimazole, who tested positive for insulin antibodies, and was diagnosed with insulin autoimmune syndrome. DIAGNOSIS: All 3 patients were diagnosed with nondiabetic hypoglycemia, but the causes varied, and included insulinoma, non-islet cell tumor-induced hypoglycemia, and insulin autoimmune syndrome. INTERVENTIONS: Case 1 underwent pancreatic tail resection; case 2 refused anti-tumor treatment and received glucose injections for palliative treatment only; and case 3 stopped taking methimazole. OUTCOMES: After surgery, the blood sugar in case 1 returned to normal, and the blood sugar in case 2 was maintained at about 6.0 mmol/L. The symptoms of hypoglycemia gradually improved in case 3 after stopping the medication. LESSONS: Non-diabetic hypoglycemia requires further examination to clarify the cause, and the correct differential diagnosis can provide timely and effective treatment, improving the patient's prognosis.

Immune checkpoint inhibitor- and phosphatidylinositol-3-kinase inhibitor-related diabetes induced by antineoplastic drugs: two case reports and a literature review.

Immune checkpoint inhibitor (ICI)- and phosphatidylinositol-3-kinase inhibitor (PI3Ki)-related diabetes mellitus are common side effects of anti-tumor drug use that present mainly as hyperglycemia. Here, we present two case reports of diabetes mellitus caused by the use of tremelimumab and apalutamide, respectively, in cancer treatment, and a comprehensive, comparative review of the literature on these forms of diabetes. Case 1 presented with diabetic ketoacidosis and was diagnosed with ICI-related diabetes mellitus and treated with insulin. Case 2 was diagnosed with PI3Ki-related diabetes mellitus, and her blood glucose level returned to normal with the use of metformin and dapagliflozin. We systematically searched the PubMed database for articles on ICI- and PI3Ki-related diabetes mellitus and characterized the differences in clinical features and treatment between these two forms of diabetes.

Transient low T3 syndrome in patients with COVID-19: a new window for prediction of disease severity.

Objective: To investigate the relationship of low T3 syndrome with disease severity in patients with COVID-19. Methods: The clinical data of 145 patients with COVID-19 were retrospectively collected, and patients were divided into a low T3 group and a normal T3 group. Logistic regression models were used to assess predictive performance of FT3. Receiver operating characteristic (ROC) analysis was used to evaluate the use of low T3 syndrome in predicting critical disease. Kaplan-Meier analysis was used to analyze the impact of low T3 syndrome on mortality. Results: The prevalence of low T3 level among COVID-19 patients was 34.48%. The low T3 group was older, and had lower levels of hemoglobin, lymphocytes, prealbumin, and albumin, but higher levels of white blood cells, neutrophils, CRP, ESR, and D-dimer (all p<0.05). The low T3 group had greater prevalences of critical disease and mortality (all p <0.05). Multivariate logistic regression analysis showed that the Lymphocytes, free T3 (FT3), and D-dimer were independent risk factors for disease severity in patients with COVID-19. ROC analysis showed that FT3, lymphocyte count, and D-dimer, and all three parameters together provided reliable predictions of critical disease. Kaplan-Meier analysis showed the low T3 group had increased mortality (p<0.001). Six patients in the low T3 group and one patient in the normal T3 group died. All 42 patients whose T3 levels were measured after recovery had normal levels after discharge. Conclusion: Patients with COVID-19 may have transient low T3 syndrome at admission, and this may be useful for predicting critical illness.

Virtual versus jaw simulation in inlay preparation preclinical teaching: a randomised controlled trial.

BACKGROUND: To investigate the effect of virtual simulation systems on the teaching of inlay experiments and to guide the experimental teaching of tooth preparation. METHODS: Participants in their second semester of the junior year were selected to carry out the unified teaching and evaluation of dental preparation theory. The age varied from 18 to 22 years (19.96 ± 0.70) and the participants were randomly divided into four groups (n = 19) with a similar male-to-female ratio following CONSORT guidelines, including a jaw simulation model training group (Group J), a virtual simulation system training group (Group V), a jaw model training first followed by a virtual system training group (Group J-V), and a virtual system followed by a jaw model training group (Group V-J). The inlay tooth preparation assessment was performed on the extracted teeth. The data were analysed according to the assessment scores by a senior clinician. The subjective feelings of the students towards the system were evaluated using questionnaires. RESULTS: The second theoretical scores of Group V-J (63.5 ± 2.89) and Group J-V (60.5 ± 3.25) were higher than those of Group V (57.5 ± 3.13) and Group J (58.0 ± 3.67). The experimental scores of Groups J-V and V-J (62.79 ± 2.84; 64.00 ± 2.85) were higher than those of Groups V and J (56.05 ± 3.39; 55.74 ± 2.53). The questionnaire survey illustrated that most students preferred the digital virtual simulation system (perfect assessment: 91.3%, accuracy: 82.6%, satisfaction: 52.2%). CONCLUSION: Virtual simulation training can facilitate the teaching effect of tooth preparation in inlay experiments, and the teaching mode of Group V-J was the best. Therefore, this teaching mode is to be popularised.

Opposite effects of nutrient enrichment and an invasive snail on the growth of invasive and native macrophytes.

Many ecosystems are now co-invaded by alien plant and herbivore species. The evolutionary naivety of native plants to alien herbivores can make the plants more susceptible to the detrimental effects of herbivory than co-occurring invasive plants, in accordance with the apparent competition hypothesis. Moreover, the invasional meltdown hypothesis predicts that in multiply invaded ecosystems, invasive species can facilitate each other's impacts on native communities. Although there is growing empirical support for these hypotheses, facilitative interactions between invasive plants and herbivores remain underexplored in aquatic ecosystems. Many freshwater ecosystems are co-invaded by aquatic macrophytes and mollusks and simultaneously experience nutrient enrichment. However, the interactive effects of these ecological processes on native macrophyte communities remain an underexplored area. To test these effects, we performed a freshwater mesocosm experiment in which we grew a synthetic native community of three macrophyte species under two levels of invasion by an alien macrophyte Myriophyllum aquaticum (invasion vs. no invasion) and fully crossed with two levels of nutrient enrichment (enrichment vs. no enrichment) and herbivory by an invasive snail Pomacea canaliculata (herbivory vs. no herbivory). In line with the invasional meltdown and apparent competition hypotheses, we found that the proportional aboveground biomass yield of the invasive macrophyte, relative to that of the native macrophyte community, was significantly greater in the presence of the invasive herbivore. Evidence of a reciprocal facilitative effect of the invasive macrophyte on the invasive herbivore is provided by results showing that the herbivore produced greater egg biomass in the presence versus in the absence of M. aquaticum. However, nutrient enrichment reduced the mean proportional aboveground biomass yield of the invasive macrophyte. Our results suggested that herbivory by invader P. canaliculata may enhance the invasiveness of M. aquaticum. However, nutrient enrichment of habitats that already harbor M. aquaticum may slow down the invasive spread of the macrophyte. Broadly, our study underscores the significance of considering several factors and their interactions when assessing the impact of invasive species, especially considering that many habitats experience co-invasion by plants and herbivores and simultaneously undergo various other disturbances, including nutrient enrichment.

Differences in Supragingival Microbiome in Patients with and without Full-Crown Prostheses.

Objectives: To characterize the microflora profile of supragingival biofilm in patients with and without full-crown prostheses. Methods: Plaque samples of full-crown prostheses and teeth in patients with porcelain-fused-to-metal crowns, all-ceramic crowns, and no prostheses were collected (three patients per group), using 16S rRNA high-throughput sequencing technology to conduct DNA sequencing on the samples and using Qiime, R, and PICRUSt2 software to perform bioinformatics analyses and functional analyses on sequencing data. Results: In total, 110,209 valid sequences were obtained in the experiment, corresponding to 11 phyla and 120 genera. The predominant species shared by the three groups were phyla Actinobacteria, Bacteroidetes, Firmicutes, Fusobacteria, and Proteobacteria and genera Rothia, Porphyromonas, Prevotella, Streptococcus, Veillonella, Leptotrichia, Neisseria, Citrobacter, and Pseudomonas. The species-difference analysis showed that genus Hameophilus significantly increased after the patient wore the dental prosthesis. Compared with the no-prosthesis samples, the functional analysis showed that cell motility increased in the samples from full-crown prostheses, while replication and repair, and translation decreased. Conclusions: This study reveals the changes in the oral microbial community of patients with full-crown prostheses, which could provide insights regarding the safety of materials for long-term use in the oral cavity.

Early renal impairment is associated with in-hospital death of patients with COVID-19.

INTRODUCTION: Renal impairment is a common complication in coronavirus disease 2019 (COVID-19), although its prognostic significance remains unknown. OBJECTIVES: This study determines the impact of early renal impairment on the clinical outcome of COVID-19. METHODS: Patients diagnosed with COVID-19 and hospitalized in Xiaogan Central Hospital from 20 January to 29 February 2020 were retrospectively included and grouped into two cohorts (cohort with normal renal function and cohort with renal insufficiency) based on the renal function detected on admission. Records of clinical manifestation, laboratory findings and clinical outcome were collected and compared between these two cohorts. RESULTS: A total 543 COVID-19 patients were included. Among these patients, 70 patients developed early renal impairment, with an incidence of 12.89%. A significantly higher white blood cell (WBC) count, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), serum creatine (Cr), blood urine nitrogen (BUN) and brain natriuretic peptide (BNP) and a significantly lower blood platelet (PLT), lymphocyte count, prealbumin and albumin (ALB) were detected in the cohort with renal insufficiency (P < 0.05). Patients with early renal impairment were also associated with higher incidences of haematuria/proteinuria, higher incidences of mortality and prolonged hospitalization duration. The independent risk factors for in-hospital death included age >65 years old, complication of diabetes, renal impairment on admission (Cr > 73 µmol/L and eGFR < 60 ml/min 1.73 m2 ), WBC > 9.5 × 109 /L and ALB < 35 g/L. CONCLUSION: Early renal impairment is associated with higher risk of in-hospital death for patients with COVID-19. Risk stratification according to renal function can better guide the clinical management of COVID-19.

B-doped graphene quantum dots implanted into bimetallic organic framework as a highly active and robust cathodic catalyst in the microbial fuel cell.

Developing efficient and durable oxygen reduction reaction (ORR) cathodic catalysts plays an essential role in application of microbial fuel cells (MFCs). Herein, the B-doped graphene quantum dots implanted into bimetallic organic framework (BGQDs/MOF-t) are fabricated by a facile electro-deposition. Results show that, the in-situ growth of FeCoMOF on nickel foam can effectively assist construction of nanoflowers with compact connections, thus improves the conductivity. More importantly, this nano-network can serve as the template for the implantation of BGQDs through powerful interface of M-O-C bonding, avoiding π-π rearrangement and providing efficient charge transfer and abundant edge active sites. Benefitting from the enhanced electrode/electrolyte transport interface, abundant catalytic sites and low charge transfer resistance, the BGQDs/MOF-15 exhibits excellent ORR activity, superior to commercial Pt/C catalyst. In the MFC with the BGQDs/MOF-15 cathode, the maximum power density of 703.55 mW m-2 is achieved, which is 1.53 times of that of the Pt/C cathode. In addition, the BGQDs/MOF-15 cathode maintains great stability over 800 h, while that of Pt/C reduces to 61% of the initial voltage. This work opens new opportunities for developing efficient and durable MOF-derived ORR catalyst.

N, S co-doped carbon quantum dots anchoring on copper-vacancy-rich Cu nanowires/Cu foam as the cathode in microbial fuel cells: Role of C-S-Cu active site.

Oxygen reduction reaction (ORR) electrocatalysts have been considered as one of the key components in microbial fuel cells (MFCs). Heteroatom-doped carbon quantum dots (CQDs) derived from biomass have attracted wide attention due to their rich functional groups, excellent properties, and environmental friendliness. Herein, orange-peels-derived N, S co-doped carbon quantum dots (N, S-CQDs) are in-situ anchored on copper-vacancy-rich Cu nanowires/Cu foam (V-Cu NWs/CF), obtaining the N, S-CQDs/Cu2O-Cu NWs, to catalyze ORR in MFCs. The interaction between N, S-CQDs and V-Cu NWs/CF from the N, S-CQDs/Cu2O-Cu NWs is bridged by the C-S-Cu bond, which is demonstrated to be the active site towards ORR and plays an important role in promoting electron transfer by in-situ Raman and X-ray photoelectron spectroscopy characterizations. In MFCs, the maximum power density (924.5 ± 32.5 mW·m-2) of N, S-CQDs/Cu2O-Cu NWs is 1.34 times that of Pt/C (686.5 ± 28.0 mW·m-2), and its long-term stability also outperforms the Pt/C. This study provides inspiration for synthesis of efficient ORR electrocatalysts with metal-ligand active sites creating by heteroatom-doped CQDs and cationic-metal-vacancy-rich materials.

Clinical characteristics and outcomes of COVID-19 long-term nucleic acid positive patients.

OBJECTIVE: This study aimed to investigate the clinical characteristics and outcomes of coronavirus disease-19 (COVID-19) long-term nucleic acid positive patients (hereinafter referred to as CLTAPs). METHODS: Patients were recruited from the Xiaogan Central Hospital between 16 January 2020 and 28 March 2020. Among the 562 cases of patients with laboratory-identified COVID-19 infection by real-time polymerase chain reaction (qtPCR), 19 cases of COVID-19 patients with more than 41 days from the first to the last time of nucleic acid test were selected as the study group, and 76 cases of age- and gender-matched COVID-19 patients were selected as the control group (hereinafter referred to as C-CLTAPs). Demographic characteristics, clinical symptoms, laboratory examination and computed tomography (CT) imaging characteristics were retrospectively analyzed. RESULTS: On admission, among the 562 cases of patients with COVID-19, there were 398 cases of ordinary COVID-19 patients, 99 cases of severe COVID-19 patients and 99 cases of critical COVID-19 patients. CLTAPs had milder clinical symptoms and longer viral shedding time in comparison to C-CLTAPs. Compared to C-CLTAPs, CLTAPs had a lower infection index at admission. CLTAPs used less oxygen therapy and a higher proportion of hydroxychloroquine treatment in comparison to C-CLTAPs. In comparison to C-CLTAPs, CLTAPs showed slower pulmonary CT progression and faster pulmonary CT absorption. CONCLUSION: In this study, out of the 562 cases, we found 19 CLTAPs. The clinical differences between CLTAPs and C-CLTAPs were compared and analyzed. We hope that these finding can provide a theoretical basis for the treatment of CLTAPs.

Visible-light-driven Z-scheme Zn3In2S6/AgBr photocatalyst for boosting simultaneous Cr (VI) reduction and metronidazole oxidation: Kinetics, degradation pathways and mechanism.

It is urgently needed to develop high-performance materials that can synchronously remove heavy metals and organic pollutants. Herein, the visible-light responsive Zn3In2S6/AgBr composites were prepared for concurrent removals of metronidazole (MNZ) and Cr (VI). In the Cr (VI)-MNZ coexisting system, the removals of MNZ and Cr (VI) using the optimized Zn3In2S6/AgBr-15 photocatalyst reached 98.2% and 94.8% within 2 h, respectively; higher than those using counterparts. The radical species trapping and electron spin resonance (ESR) results demonstrated that ·OH was the most dominated species for MNZ oxidation, and photo-generated electrons were responsible for Cr (VI) reduction. Besides, slight competition for ·O2- during the simultaneous MNZ degradation and Cr (VI) reduction occurred. Energy band structure analysis, ESR and the outstanding photocatalytic performance for MNZ and Cr (VI) removals demonstrated that the Zn3In2S6/AgBr-15 was a Z-scheme photocatalyst, which promoted photo-induced carrier's separation. Possible MNZ degradation pathways and mechanism over the Z-scheme Zn3In2S6/AgBr were also proposed based on the identified intermediates. This study could inspire new ideas for design of efficient Z-scheme photocatalysts for wastewater treatment.

miR-874 ameliorates retinopathy in diabetic rats by NF-κB signaling pathway.

BACKGROUND: Increased activity of the NF-κB signaling pathway boosts the progression of retinopathy in diabetic rats. OBJECTIVES: Using a bioinformatics website, we identified a site where miR-874 binds to the NF-κB p65. Therefore, we speculated that miR-874 might improve retinopathy in diabetic rats by inhibiting the NF-κB signaling pathway. MATERIAL AND METHODS: Ten healthy rats were taken as the control group. Sixty streptozotocin (STZ; 60 mg/kg)-induced diabetes model rats were randomly divided into the model group (injection of normal saline), negative control (NC) agomir group (injection of NC mimic), miR-874 agomir group (injection of miR-874 mimic), miR-874 anti-agomir group (injection of miR-874 inhibitor), EVP4593 group (injection of NF-κB signaling pathway antagonist EVP4593), and miR-874 anti-agomir+EVP4593 group (injection of miR-874 inhibitor and EVP4593). All injections were administered into the caudal vein. RESULTS: miR-874 could target the degradation of p65. Compared with the control group, model rats had reduced miR-874 expression, increased vascular endothelial growth factor (VEGF) and Ang2 protein expression, lowered end-diastolic velocity (EDV) and peak systolic velocity (PSV) of the central retinal artery (CRA) and blood velocity of central retinal vein (CRV) and CRA, heightened plasma viscosity (PV), blood viscosity (BV) and erythrocyte sedimentation rate (ESR) at all shear rates, decreased capillary pericytes (IPCs), increased vascular endothelial cells (VECs), and ascended p65 expression in the retina (all p < 0.05). Thus, it was shown that pathological changes appeared in the retina of diabetic rats. These indices improved in diabetic rats injected with the miR-874 mimic or EVP4593, but deteriorated in those injected with miR-874 inhibitor (all p < 0.05). EVP4593 also could alleviate the aggravation of retinopathy that was caused by miR-874 inhibition in diabetic rats. CONCLUSIONS: miR-874 modulates the NF-κB signaling pathway by targeting the degradation of p65 to further improve the retina of diabetic rats, thus demonstrating the beneficial effect of miR-874 on diabetic retinopathy in rats.

Analysis of clinical features and pulmonary CT features of coronavirus disease 2019 (COVID-19) patients with diabetes mellitus.

INTRODUCTION: The objective of this paper was to investigate the clinical features and pulmonary CT imaging features of COVID-19 patients with diabetes mellitus. MATERIAL AND METHODS: From January 16, 2020 to March 28, 2020, among the 568 cases of COVID-19 patients diagnosed in Xiaogan Central Hospital, 64 cases of COVID-19 patients with diabetes were selected as the diabetic group, and 64 cases of COVID-19 patients with age and gender matching without diabetes were selected as the non-diabetic group, and their clinical data and pulmonary CT characteristics were retrospectively analysed. RESULTS: Compared with the non-diabetic group, the proportion of patients in the diabetic group with chronic underlying disease was higher, and they were in more a serious condition at admission. Inflammation index and characteristics of glycolipid metabolism results showed that COVID-19 patients with diabetes mellitus were more likely to have elevated inflammatory markers and hypercoagulability, accompanied by hypoproteinaemia and glucose and lipid metabolism disorders. Treatment and clinic outcome results showed that the time of nucleic acid turning negative in the diabetic group was significantly longer than that in the non-diabetic group. Radiological data showed that COVID-19 combined with diabetes prolonged the time of detoxification in patients. CONCLUSION: COVID-19 patients with diabetes mellitus and chronic hypertension are associated with increased inflammatory markers and disorders of glucose and lipid metabolism. These patients tend to develop serious diseases, especially the rapid progression of CT lesions in the lungs of patients with a wide range ofinvolvement, and prolonged absorption and detoxification time.

Convalescent plasma therapy in critically ill coronavirus disease 2019 patients with persistently positive nucleic acid test, case series report.

INTRODUCTION: Globally, the coronavirus disease 2019 (COVID-19) is still spreading rapidly. At present, there are no specifically approved therapeutic agents or vaccines for its treatment. Previous studies have shown that the convalescent plasma therapy (CPT) is effective in patients with COVID-19. However, its efficacy in patients with persistently positive nucleic acid test is unknown. PATIENT CONCERNS: In this report, we present the clinical data of 5 critically ill COVID-19 patients admitted, between January 16 and February 26, 2020, in intensive care unit of Xiaogan Central Hospital. DIAGNOSIS AND INTERVENTIONS: All these patients had a persistently positive nucleic acid test and received CPT. All 5 patients had severe respiratory failure, and thus, required invasive mechanical ventilation. The median time from the onset of symptoms to initiating the CPT was 37 (Interquartile range, 34-44) days. OUTCOMES: Only 2 patients were cured and subsequently discharged, while 3 patients succumbed due to multiple organ failure. CONCLUSION: The time of initiating the CPT may be an important factor affecting its efficacy, and its therapeutic effect in the treatment of COVID-19, in the late stage, is limited.

COVID-19 with rheumatic diseases: a report of 5 cases.

The coronavirus disease 2019 (COVID-19), the result of an infection with the new virus, SARS-CoV-2, is rapidly spreading worldwide. It is largely unknown whether the occurrence of COVID-19 in patients with rheumatic immune diseases has some specific manifestations, or makes them more prone to rapidly progress into severe COVID-19. In this case report, we describe the clinical features of 5 rheumatic immune disease patients with the concomitant presence of COVID-19. Amongst these patients, 4 had rheumatoid arthritis (RA) and 1 had systemic sclerosis (SSc). Two patients had a history of close contact with a COVID-19 patient. The age of the patients ranged between 51 and 79 years. Fever (80%), cough (80%), dyspnea (40%), and fatigue (20%) were the most common presenting symptoms. Laboratory investigations revealed leukopenia and lymphopenia in 2 patients. In all the patients, chest computerized tomography (CT) revealed patchy ground glass opacities in the lungs. During the hospital stay, the condition of two patients remained the same (i.e., mild COVID-19), two patients progressed to the severe COVID-19, and one patient worsened to the critically ill COVID-19. These patients were treated with antiviral agents for COVID-19, antibiotics for secondary bacterial infections, and immunomodulatory agents for rheumatic immune diseases. All the patients responded well, were cured of COVID-19, and subsequently discharged.