A Nomogram for Early Diagnosis of Community-Acquired Pneumonia Based on Bronchoalveolar Lavage Fluid Metabolomics.

Purpose: There is a high disease burden associated with community-acquired pneumonia (CAP) around the world. A timely and correct diagnosis of CAP can facilitate early treatment and prevent illness progression. The present study aimed to find some novel biomarkers of CAP by metabolic analysis and construct a nomogram model for precise diagnosis and individualized treatment of CAP patients. Patients and Methods: 42 CAP patients and 20 controls were enrolled in this study. The metabolic profiles of bronchoalveolar lavage fluid (BALF) samples were identified by untargeted LC-MS/MS analysis. With a VIP score ≥ 1 in OPLS-DA analysis and P < 0.05, the significantly dysregulated metabolites were estimated as potential biomarkers of CAP, which were further included in the construction of the diagnostic prediction model along with laboratory inflammatory indexes via stepwise backward regression analysis. Discrimination, calibration, and clinical applicability of the nomogram were evaluated by the C-index, the calibration curve, and the decision curve analysis (DCA) estimated by bootstrap resampling. Results: The metabolic profiles differed obviously between CAP patients and healthy controls, as shown by PCA and OPLS-DA plots. Seven metabolites significantly dysregulated in CAP were established: dimethyl disulfide, oleic acid (d5), N-acetyl-a-neuraminic acid, pyrimidine, choline, LPC (12:0/0:0) and PA (20:4/2:0). Multivariate logistic regression revealed that the expression levels of PA (20:4/2:0), N-acetyl-a-neuraminic acid, and CRP were associated with CAP. After being validated by bootstrap resampling, this model showed satisfactory diagnostic performance. Conclusion: A novel nomogram prediction model containing metabolic potential biomarkers in BALF that was developed for the early diagnosis of CAP offers insights into the pathogenesis and host response in CAP.

TAFRO syndrome with fatigue and abdominal distension as the first symptom: A case report.

TAFRO syndrome is a peculiar and rare type of multi-centric Castleman's disease which contained a series of symptoms such as thrombocytopenia (T), anasarca (A), fever (F), reticulin fibrosis (R), and organomegaly (O). Here we provide a case of TAFRO syndrome with the manifestation of fatigue, abdominal distension, and low fever at primary diagnosis, characterized by multiple lymphadenopathy of superficial mediastinal and retroperitoneal lymph nodes, and it was finally confirmed by lymph node biopsy. The patient recovered speedy after receiving CHOP chemotherapy. In this case report, the patient has a history of dust-exposure and hepatitis B virus infection, which may be potentially related to the disease. In addition, this case suggests the importance of pathological biopsy of complete lymph nodes in diagnostic process.

Diagnostic Significance of Metagenomic Next-Generation Sequencing for Community-Acquired Pneumonia in Southern China.

BACKGROUND: The morbidity and mortality of community-acquired pneumonia are relatively high, but many pneumonia pathogens cannot be identified accurately. As a new pathogen detection technology, metagenomic next-generation sequencing (mNGS) has been applied more and more clinically. We aimed to evaluate the diagnostic significance of mNGS for community-acquired pneumonia (CAP) in the south of China. METHODS: Our study selected CAP patients who visited the 3rd Xiangya Hospital from May 2019 to April 2021. Pathogens in bronchoalveolar lavage fluid (BALF) specimens were detected using mNGS and traditional microbiological culture. mNGS group: detected by both mNGS and BALF culture; control group: detected only by BALF or sputum culture. The diagnostic performance of pathogens and the antibiotic adjustments were compared within mNGS group. RESULTS: The incidence of acute respiratory distress syndrome (ARDS) was 28.3% in the mNGS group and 17.3% in the control group. Within the mNGS group, the positive rate of pathogens detected by mNGS was 64%, thus by BALF culture was only 28%. Pathogens detected by mNGS were consisted of bacteria (55%), fungi (18%), special pathogens (18%), and viruses (9%). The most detected pathogen by mNGS was Chlamydia psittaci. Among the pathogen-positive cases, 26% was not pathogen-covered by empirical antibiotics, so most of which were made an antibiotic adjustment. CONCLUSIONS: mNGS can detect pathogens in a more timely and accurate manner and assist clinicians to adjust antibiotics in time. Therefore, we recommend mNGS as the complementary diagnosis of severe pneumonia or complicated infections.

[Aortic valve degenerative disease with patent ductus arteriosus infective endocarditis: A case report].

OBJECTIVE: Infective endocarditis (IE) refers to the pathogenic microbial infect the endocardium, valves or intima adjacent to the cardiac arteries through the bloodstream with the formation of vegetations. Valves are the most frequently affected sites. Here, we described a 49-year-old female, who admitted to respiratory outpatient department in the Third Xiangya Hospital, Central South University for long time of fever. Chest computer tomography (CT) found a thick wall cavity in the apex of the right lung with smooth wall and fluid plane, without enhancement, which was considered as inflammation and tuberculosis to be excluded. Echocardiography showed vegetations on the aortic valve, where abscess was found on the root. Accidentally in surgery, a patent ductus arteriosus (PDA) was found. The surgeon closed the PDA and performed aortic valve prosthetic valve replacement. Bacterial colony of coccus was found in the pathological tissue, which was consistent with the diagnosis of valvular degeneration with infection. Lung lesion was obviously absorbed after 6 weeks of treatment with vancomycin, which has been confirmed as a sensitive antibacterial drug to Enterococcus faecalis. Overall, the pulmonary lesion was caused by the detachment of bacterial neoplasm of aortic valve, which has passed through the PDA and entered the pulmonary circulation.

Improve optics fabrication efficiency by using a radio frequency ion beam figuring tool.

An ion beam with high removal rate and small diameter is expected in ion beam figuring. For an ion beam figuring tool, reducing the extraction grid opening is a feasible method to decrease the ion beam diameter, but the ion beam removal rate decreases at the same time. The ion beam removal rate depends much on the ion density in the ion source discharge room. The plasma in a hollow cathode (HC) ion source and a radio frequency (RF) ion source was simulated. The simulations suggested that the ion density in the RF ion source is higher than that of the HC one. Then, a RF ion source with an integrative matching network was developed and tested in this paper, where the ion beam removal rate reached up to 193 nm/min for 10 mm opening extraction grids.

Effect of the focal shaping generated from different double-mode cylindrical vector beams.

We investigate three-dimensional focus shaping generated from double-mode cylindrical vector beams with the Gaussian and Bessel-Gaussian pupil apodization functions by choosing the suitable polarization states of beams. Further, we compare them with that generated from the Laguerre-Gaussian pupil apodization function in the same situation. We find that the focus shaping generated from the Gaussian beam has the smallest zero intensity spot size. However, the situation of the Bessel-Gaussian beam not only possesses stability, which makes it suitable when applied in optical trapping, but also shows the best uniformity, which indicates its excellent performance in super-resolution fluorescence microscopy.

The role of silver and gold nanoparticles in enhancing luminescence of europium complexes.

The influence of 12 nm spherical silver nanoparticles (AgNPs) and 20 nm spherical gold nanoparticles (AuNPs) on the luminescence of europium complex Eu(TTFA)3 were studied. When 350 nm is chosen as the incident light, the maximum enhancement factor of the complexes mixed with AgNPs is about 2.5 at the wavelength of 612 nm. Besides the enhancement of the localized field, the overlap between the localized surface plasmon resonance spectra of nanoparticles and the absorption band of fluorescent molecules is another important factor for excitation field enhancement. By means of the quasi-static approximation theory, the distribution of the electric field around a single spherical metallic nanopaticle illuminated by plane wave was calculated. The simulation results show that the field enhancement effect is more obvious when the incident light is close to the resonance of the metallic nanoparticle, which could be demonstrated by our following experimental results. The distribution of the electric field under the same conditions was also simulated through the COMSOL software. The results are consistent with those of the quasi-static approximation theory.

Sharper focal spot generated by 4π tight focusing of higher-order Laguerre-Gaussian radially polarized beam.

The focal electric fields for a 4π high numerical aperture (NA) focusing system with both the doughnut and higher-order Laguerre-Gaussian (LG) radially polarized (RP) beams are investigated in the case of NA=1, and the full width at half-maximum values of the focal spots are calculated. Compared with the single-lens high NA focusing configuration, a sharper spot, whose size is reduced efficiently in the transverse as well as the axial direction, can be formed. Such size reduction is attributed to not only the destruction interference of the longitudinal component caused by the π phase shift between any two adjacent rings of the incident higher-order LG RP beam coming from one particular direction but also the perfect destruction interference of the radial component formed by the two counter-propagating incident beams.

Enantioselective syntheses of rigidiusculamides A and B: revision of the relative stereochemistry of rigidiusculamide A.

The first enantioselective synthesis of cytotoxic natural products rigidiusculamides A (ent-21) and B (8) has been achieved by two synthetic routes. The first one is convergent based on the common intermediate 11, obtained through a high yielding SmI(2) -mediated Reformatsky-type reaction. A highly diastereoselective one-pot Dess-Martin periodinane-mediated bis-oxidation allowed the direct conversion of the diastereomeric mixture of 11 into rigidiusculamide B (8). Isolation of minor diastereomer 21, in combination with computational work, allowed us to suggest the structure of the natural rigidiusculamide A to be ent-21, as synthesized by the second route. Four diastereomers (7, ent-7, 22a, and 22b) and an enantiomer (21) of rigidiusculamide A (ent-21) have been synthesized. On the basis of literature precedents and computational work, a biosynthetic pathway for rigidiusculamides A and B was proposed to account for the opposite configuration at C-5 of those two congeners.

[Enantioseparation of 1,1'-bi-2-naphthol benzoates using high performance liquid chromatography].

The enantioseparations of 2'-hydroxy-1,1'-binaphthyl-2-yl benzoate (HBNB), 1,1'-binaphthyl-2,2'-diyl dibenzoate (BNDB) and 2'-methoxy-1,1'-binaphthyl-2-yl benzoate (MBNB) were studied on Chirex (S)-LEU & (S)-NEA, cellulose tris (3,5-dimethylphenylcarbamate) (Chiralcel OD-H) and amylose tris (3,5-dimethylphenyl-carbamate) (Chiralpak AD-H) columns, respectively, using high performance liquid chromatography. The effects of mobile phase, column temperature and compound structures on the enantioseparations were discussed. The Chiralpak AD-H exhibited stronger capability of enantioseparation in comparison with those of Chirex (S)-LEU & (S)-NEA and Chiralcel OD-H for 1,1'-bi-2-naphthol benzoates. When using the mobile phase of n-hexane/2-propanol (40/60, v/v), the chiral selectivities of HBNB, BNDB and MBNB were 1.76, 1.74, and 1.40, respectively. Moreover, in comparison with that of 1,1'-bi-2-naphthol (BN), the mechanisms of the enantioseparation of 1,1'-bi-2-naphthol benzoates, related to the substituted groups at 2-position, the elution orders and thermodynamic parameters were also discussed.