Immune Dysfunction-Associated Elevated RDW, APACHE-II, and SOFA Scores Were a Possible Cause of 28-Day Mortality in Sepsis Patients.

Objective: To explore the early predictors and their predicting value of 28-day mortality in sepsis patients and to investigate the possible causes of death. Methods: 127 sepsis patients were included, including 79 cases in the survival group and 48 cases in the death group. The results of all patients on admission were recorded. After screening the risk factors of 28-day mortality, the receiver operating characteristic curve (ROC) was used to determine their predictive value for the 28-day mortality rate on admission, and the Kaplan-Meier curve was drawn to compare the 28-day mortality rate between groups. Finally, patients with cytokine and lymphocyte subsets results were included for investigating the possible causes of death through correlation analysis. Results: APACHE II (acute physiology and chronic health evaluation II), SOFA (Sequential Organ Failure Assessment) and red blood cell distribution width (RDW) were the risk factors for 28-day mortality in sepsis patients (OR: 1.130 vs.1.160 vs.1.530, P < 0.05). The area under the curve (AUC), sensitivity and specificity of APACHE II, SOFA and RDW in predicting the mortality rate at 28 days after admission in sepsis patients were 0.763 vs 0.806 vs 0.723, 79.2% vs 68.8% vs 75.0%, 65.8% vs 89.9% vs 68.4%. The combined predicted AUC was 0.873, the sensitivity was 89.6%, and the specificity was 82.3%. The Kaplan-Meier survival curve showed that the 28-day mortality rates of sepsis patients with APACHE II≥18.5, SOFA≥11.5 and RDW≥13.8 were 58.5%, 80.5% and 59.0%, respectively. In the death group, APACHE II was positively correlated with SOFA, IL-2, and IL-10, and RDW was positively correlated with PLT, TNF-α, CD3+ lymphocyte count, and CD8+ lymphocyte count. Conclusion: Sepsis patients with high APACHE II, SOFA and RDW levels at admission have an increased 28-day mortality rate. The elevation of these indicators in dead patients are related to immune dysfunction.

Stress-induced hyperglycemia is associated with the mortality of thrombotic thrombocytopenic purpura patients.

BACKGROUND: Thrombotic thrombocytopenic purpura (TTP) is a rare thrombotic microangiopathy with a rapid progression and high mortality rate. We aimed to explore early risk factors for mortality in patients with TTP. METHODS: We conducted a retrospective analysis of 42 TTP patients that were admitted to our hospital between 2000 and 2021, with a median age of 49 (29-63) years. Risk factors for mortality were evaluated using multivariate logistic regression. Receiver operating characteristic curve analysis was used to determine the cut-off value of glucose for predicting mortality in patients, which was validated by comparison to a similar cohort in the published literature. RESULTS: Elevated glucose level and reduced red blood cells (RBC) counts were risk factors for mortality in patients with TTP (glucose, odds ratio and 95% confidence interval: 2.476 [1.368-4.484]; RBC, odds ratio and 95% confidence interval: 0.095 [0.011-0.799]). The area under the curve of glucose was 0.827, and the cut-off value was 9.2 mmol/L, with a sensitivity of 75.0% and specificity of 95.8%. A total of 26 cases from the validation cohort had a sensitivity of 71.0% and a specificity of 84.0%. The change trends of the TTP-related laboratory indices differed during hospitalization. CONCLUSION: Hyperglycemia at admission and unstable blood glucose levels during hospitalization may be potential predictors of mortality for TTP patients. The improved prognosis was associated with the recovery of platelet counts and a significant decrease in serum lactate dehydrogenase after five days of treatment.

Electrostatic discharge induced degradation of optical-electrical properties and defect evolution of GaAs-based oxide-confined VCSELs.

GaAs-based oxide-confined vertical-cavity surface-emitting lasers (VCSELs) exhibit relatively low resistance against reliability-related damage. In order to gain a deeper understanding of the degradation and failure mechanism in oxide-confined VCSELs caused by electrostatic discharge (ESD)-induced defect proliferation, we investigated the effects of ESD stress on the degradation of optical-electrical characteristics and the evolution of defects in VCSELs under human body model test condition. The degradation threshold values for forward and reverse ESD pulse amplitudes were estimated to be 200 V and -50 V, respectively. Notably, VCSELs demonstrated greater sensitivity to reverse bias ESD compared to forward bias ESD. Analysis of optical emission and microstructure provided evidence that the device failure is attributed to an increase in ESD current density, leading to the multiplication of dark line defects (DLDs) originating from the edge of the device's oxide aperture. The formation of defects occurred suddenly in discrete events within small regions, rather than progressing gradually and uniformly. These defects propagated and led to damage across the entire active region. We believe that our results would be meaningful for improving the reliability of VCSEL in the future.

The Influence of Special Environments on SiC MOSFETs.

In this work, the influences of special environments (hydrogen gas and high temperature, high humidity environments) on the performance of three types of SiC MOSFETs are investigated. The results reveal several noteworthy observations. Firstly, after 500 h in a hydrogen gas environment, all the SiC MOSFETs exhibited a negative drift in threshold voltage, accompanied by an increase in maximum transconductance and drain current (@ VGS/VDS = 13 V/3 V). This phenomenon can be attributed to that the hydrogen atoms can increase the positive fixed charges in the oxide and increase the electron mobility in the channel. In addition, high temperature did not intensify the impact of hydrogen on the devices and electron mobility. Instead, prolonged exposure to high temperatures may induce stress on the SiO2/SiC interface, leading to a decrease in electron mobility, subsequently reducing the transconductance and drain current (@ VGS/VDS = 13 V/3 V). The high temperature, high humidity environment can cause a certain negative drift in the devices' threshold voltage. With the increasing duration of the experiment, the maximum transconductance and drain current (@ VGS/VDS = 18V (20 V)/3 V) gradually decreased. This may be because the presence of moisture can lead to corrosion of the devices' metal contacts and interconnects, which can increase the devices' resistance and lead to a decrease in the devices' maximum transconductance and drain current.

Effect of Electro-Thermo-Mechanical Coupling Stress on Top-Cooled E-Mode AlGaN/GaN HEMT.

This work investigated the effects of single stress and electro-thermo-mechanical coupling stress on the electrical properties of top-cooled enhancement mode (E-mode) Aluminium Gallium Nitride/Gallium Nitride (AlGaN/GaN) high electron mobility transistor (HEMT) (GS66508T). Planar pressure, linear deformation, punctate deformation, environmental temperature, electro-thermal coupling, thermo-mechanical coupling, and electro-thermo-mechanical coupling stresses were applied to the device. It was found that different kinds of stress had different influence mechanisms on the device. Namely, excessive mechanical pressure/deformation stress caused serious, irrecoverable degradation of the device's leakage current, with the gate leakage current (Ig) increasing by ~107 times and the drain-to-source leakage current (Idss) increasing by ~106 times after mechanical punctate deformation of 0.5 mm. The device characteristics were not restored after the mechanical stress was removed. Compared with three mechanical stresses, environmental thermal stress had a greater influence on the device's transfer characteristic and on-resistance (Ron) but far less influence on Ig and Idss. As was expected, multiple stress coupled to the device promoted invalidation of the device. For more in-depth investigation, finite element simulation carried out with COMSOL was used to analyze the effect of electro-thermo-mechanical coupling stress on top-cooled E-mode AlGaN/GaN HEMT. The results of the experiments and simulation demonstrated that single and coupled stresses, especially mechanical stress coupled with other stresses, degraded the electrical properties or even caused irreversible damage to top-cooled E-mode AlGaN/GaN HEMT. Mechanical stress should be reduced as much as possible in the packaging design, transportation, storage, and application of top-cooled E-mode AlGaN/GaN HEMT.

Investigation of the Possible Causes of NRBC in ICU Patients and the Dynamic Trend of NRBC Count in Survival and Death Patients or with Different Underlying Diseases: A Retrospective Study.

Background: The mortality of intensive care unit (ICU) patients ranges from 5% to 30%, and nucleated red blood cells (NRBCs) were revealed to be related to mortality. However, few studies have discussed the causes of NRBC or compared the dynamic count among patients with underlying diseases. Aim: To explore the possible causes of NRBC in ICU patients and the dynamic trends between survival and death groups and underlying disease subgroups. Methods: A total of 177 ICU patients were retrospectively included. The possible causes of NRBC in ICU patients were discussed. The relationship between NRBC and in-hospital mortality and the dynamic trend of NRBC during hospitalization between the survival and death groups and underlying disease subgroups were compared. Results: The Acute Physiology and Chronic Health Evaluation II (APACHE II) score and Sequential Organ Failure Assessment (SOFA) score in the NRBC-positive group were higher (23.52 ± 9.39 vs. 19.62 ± 7.59; 13.50 (9.00-17.50) vs. 8.00 (6.00-12.00)). Red blood cell count (RBC), hemoglobin (Hb) level, oxygen saturation (SO2), oxygenation index (OI), and serum protein level were lower in the NRBC-positive group. However, D-dimer (D-D), liver and kidney function indices, lactate dehydrogenase (LDH), C-reactive protein (CRP), and procalcitonin (PCT) were higher than those in the NRBC-negative group. Correlation analysis showed that NRBC count was positively correlated with alkaline phosphatase (ALP) and red blood cell distribution width (RDW) and negatively correlated with SO2 (r = 0.431, P < 0.05; r = 0.363, P < 0.05; r = -0.335, P < 0.05). The mortality rate in the NRBC-positive group was higher, and the median survival time was shorter than that in the NRBC-negative group (77.9% vs. 95.7%, P < 0.001; 15 days vs. 8.5 days, P < 0.01). Univariate and multivariate Cox regression analyses showed that NRBC was an independent risk factor for in-hospital mortality (HR: 1.12 (1.03-1.22), P < 0.01). The NRBC count had different hazard ratios (HRs) for in-hospital mortality in the subgroups. Locally weighted scatterplot smoothing (LOWESS) analysis revealed that the NRBC count in the death group was higher and had a sharp upward trend before death, whereas that in the survival group was negative or stayed at a low level. The changing trend of the NRBC count was different in patients with different underlying diseases. Conclusion: The possible cause of NRBC in ICU patients was related to inflammation and hypoxia. The persistently high level and rapid upward trend of NRBC counts are risk factors for in-hospital mortality in ICU patients. The changing trend of the NRBC count varied in patients with different underlying diseases.

The Electrical and Thermal Characteristics of Stacked GaN MISHEMT.

To study the working performance of 3D stacked chips, a double-layer stacked GaN MISHEMTs structure was designed to study the electro-thermal characteristics and heat transfer process of stacked chips. Firstly, the electrical characteristics of double-layer and single-layer GaN MISHEMTs are compared at room temperature. Under the same conditions, the output current of double-layer GaN MISHEMTs is twice that of single-layer GaN MISHEMTs, but its off-state current is much higher than that of a single-layer device. Meanwhile, there is no significant difference between the threshold voltages of the double-layer and single-layer GaN MISHEMTs. Then, the effect of temperature on the electrical characteristics of double-layer GaN MISHEMTs is also investigated. When the temperature increased from room temperature to 150 °C, the device's threshold voltage gradually shifted negatively, the output current of the device decreased, and the off-state current of the device increased. Furthermore, a thermal resistance network model has been established to analyze the thermal characteristics of the stacked GaN MISHEMTs. The relative error between the results calculated according to the model and the experimental results does not exceed 4.26%, which verified the correctness and accuracy of the presented model to predict the temperature distribution of the stacked GaN MISHEMTs.

Development and validation a simple scoring system to identify malignant pericardial effusion.

Background: Malignant pericardial effusion (MPE) is a serious complication in patients with advanced malignant tumors, which indicates a poor prognosis. However, its clinical manifestations lack specificity, making it challenging to distinguish MPE from benign pericardial effusion (BPE). The aim of this study was to develop and validate a scoring system based on a nomogram to discriminate MPE from BPE through easy-to-obtain clinical parameters. Methods: In this study, the patients with pericardial effusion who underwent diagnostic pericardiocentesis in Taizhou Hospital of Zhejiang Province from February 2013 to December 2021 were retrospectively analyzed. The eligible patients were divided into a training group (n = 161) and a validation group (n = 66) according to the admission time. The nomogram model was established using the meaningful indicators screened by the least absolute shrinkage and selection operator (LASSO) and multivariate logistic regression. Then, a new scoring system was constructed based on this nomogram model. Results: The new scoring system included loss of weight (3 points), no fever (4 points), mediastinal lymph node enlargement (2 points), pleural effusion (6 points), effusion adenosine deaminase (ADA≦18U/L) (5 points), effusion lactate dehydrogenase (LDH>1033U/L) (7 points), and effusion carcinoembryonic antigen (CEA>4.9g/mL) (10 points). With the optimal cut-off value was 16 points, the area under the curve (AUC), specificity, sensitivity, positive predictive value (PPV), negative predictive value (NPV), positive likelihood ratio (PLR), negative likelihood ratio (NLR) for identifying MPE were 0.974, 95.1%, 91.0%, 85.6%, 96.8%, 10.56 and 0.05, respectively, in the training set and 0.950, 83.3%, 95.2%, 90.9%, 90.9%, 17.50, and 0.18, respectively, in the validation set. The scoring system also showed good diagnostic accuracy in differentiating MPE caused by lung cancer from tuberculous pericardial effusion (TPE) and MPE including atypical cell from BPE. Conclusion: The new scoring system based on seven easily available variables has good diagnostic value in distinguishing MPE from BPE.

Elevated lactate dehydrogenase predicts poor prognosis of acute ischemic stroke.

BACKGROUND: Lactate dehydrogenase (LDH) is associated with the prognosis of many diseases, but the relationship between LDH and the poor prognosis (recurrence and death) of acute ischemic stroke (AIS) has not been fully clarified. This study aimed to investigate the association between admission LDH level and poor prognosis in patients with AIS. METHODS: This retrospective study enrolled AIS patients treated in Taizhou Hospital of Zhejiang Province from July 2019 to December 2019. Poor prognosis included AIS recurrence and all-cause death at 3, 6, and 18 months. The correction between LDH and poor prognosis or all-cause death was assessed. Lasso Cox expression and multivariate Cox expression analyses were used to evaluate the association of LDH with the risk of poor prognosis and all-cause death, respectively. A nomogram was constructed to evaluate the predictive Values of LDH for the poor prognosis and all-cause death of AIS. RESULTS: 732 patients were included in the study. Multivariate analysis shows that admission LDH levels were significantly correlated with poor prognosis [odds ratio (OR),1.003; 95% confidence interval (95% CI), 1.001-1.005; P = 0.001] and all-cause death (OR, 1.005; 95% CI, 1.000-1.009; P = 0.031). The correlation analysis showed that admission LDH level was positively correlated with National Institutes of Health Stroke Scale (NIHSS) score and modified Rankin Scale (mRS) score. Time-dependent receiver operating characteristic (td-ROC) curves analysis showed that the AUC values of admission LDH level for predicting prognosis of AIS patients in 3-month, 6-month, 12-month and 18-month were 0.706 (95% CI, 0.604-0.810), 0.653 (95% CI, 0.583-0.723), 0.616 (95% CI, 0.556-60676) and 0.610 (95% CI, 0.552-0.680), respectively. And td-ROC also showed that the AUC values of admission LDH level for predicting all-cause death of AIS patients in 3-month, 6-month,12-month and 18-month were 0.861 (95% CI, 0.764-0.958), 0.824 (95% CI, 0.753-0.890), 0.726 (95% CI, 0.633-0.819) and 0.715 (95% CI, 0.622-0.807), respectively. The nomograms were constructed to create the predictive models of the poor prognosis and all-cause death of AIS. CONCLUSION: Higher LDH levels are independently associated with poor prognosis and all-cause death of AIS.

Development and validation of a hypoxia-stemness-based prognostic signature in pancreatic adenocarcinoma.

Background: Pancreatic adenocarcinoma (PAAD) is one of the most aggressive and fatal gastrointestinal malignancies with high morbidity and mortality worldwide. Accumulating evidence has revealed the clinical significance of the interaction between the hypoxic microenvironment and cancer stemness in pancreatic cancer progression and therapies. This study aims to identify a hypoxia-stemness index-related gene signature for risk stratification and prognosis prediction in PAAD. Methods: The mRNA expression-based stemness index (mRNAsi) data of PAAD samples from The Cancer Genome Atlas (TCGA) database were calculated based on the one-class logistic regression (OCLR) machine learning algorithm. Univariate Cox regression and LASSO regression analyses were then performed to establish a hypoxia-mRNAsi-related gene signature, and its prognostic performance was verified in both the TCGA-PAAD and GSE62452 corhorts by Kaplan-Meier and receiver operating characteristic (ROC) analyses. Additionally, we further validated the expression levels of signature genes using the TCGA, GTEx and HPA databases as well as qPCR experiments. Moreover, we constructed a prognostic nomogram incorporating the eight-gene signature and traditional clinical factors and analyzed the correlations of the risk score with immune infiltrates and immune checkpoint genes. Results: The mRNAsi values of PAAD samples were significantly higher than those of normal samples (p < 0.001), and PAAD patients with high mRNAsi values exhibited worse overall survival (OS). A novel prognostic risk model was successfully constructed based on the eight-gene signature comprising JMJD6, NDST1, ENO3, LDHA, TES, ANKZF1, CITED, and SIAH2, which could accurately predict the 1-, 3-, and 5-year OS of PAAD patients in both the training and external validation datasets. Additionally, the eight-gene signature could distinguish PAAD samples from normal samples and stratify PAAD patients into low- and high-risk groups with distinct OS. The risk score was closely correlated with immune cell infiltration patterns and immune checkpoint molecules. Moreover, calibration analysis showed the excellent predictive ability of the nomogram incorporating the eight-gene signature and traditional clinical factors. Conclusion: We developed a hypoxia-stemness-related prognostic signature that reliably predicts the OS of PAAD. Our findings may aid in the risk stratification and individual treatment of PAAD patients.

An AlGaN/GaN Lateral Bidirectional Current-Regulating Diode with Two Symmetrical Hybrid Ohmic-Schottky Structures.

Bidirectional current-regulating ability is needed for AC light emitting diode (LED) drivers. In previous studies, various rectifier circuits have been used to provide constant bidirectional current. However, the usage of multiple electronic components can lead to additional costs and power consumption. In this work, a novel AlGaN/GaN lateral bidirectional current-regulating diode (B-CRD) featuring two symmetrical hybrid-trench electrodes is proposed and demonstrated by TCAD Sentaurus (California USA) from Synopsys corporation. Through shortly connecting the Ohmic contact and trench Schottky contact, the unidirectional invariant current can be obtained even with the applied voltage spanning a large range of 0-200 V. Furthermore, with the combination of two symmetrical hybrid-trench electrodes at each side of the device, the proposed B-CRD can deliver an excellent steady current in different directions. Through the TCAD simulation results, it was found that the device's critical characteristics (namely knee voltage and current density) can be flexibly modulated by tailoring the depth and length of the trench Schottky contact. Meanwhile, it was also demonstrated through the device/circuit mixed-mode simulation that the proposed B-CRD can respond to the change in voltage in a few nanoseconds. Such a new functionality combined with excellent performance may make the proposed B-CRD attractive in some special fields where the bidirectional current-limiting function is needed.

Investigation on the Thermal Characteristics of Enhancement-Mode p-GaN HEMT Device on Si Substrate Using Thermoreflectance Microscopy.

In this paper, thermoreflectance microscopy was used to measure the high spatial resolution temperature distribution of the p-GaN HEMT under high power density. The maximum temperature along the GaN channel was located at the drain-side gate edge region. It was found that the thermal resistance (Rth) of the p-GaN HEMT device increased with the increase of channel temperature. The Rth dependence on the temperature was well approximated by a function of Rth~Ta (a = 0.2). The three phonon Umklapp scattering, point mass defects and dislocations scattering mechanisms are suggested contributors to the heat transfer process for the p-GaN HEMT. The impact of bias conditions and gate length on the thermal characteristics of the device was investigated. The behaviour of temperature increasing in the time domain with 50 µs pulse width and different drain bias voltage was analysed. Finally, a field plate structure was demonstrated for improving the device thermal performance.

Improving Breakdown Voltage and Threshold Voltage Stability by Clamping Channel Potential for Short-Channel Power p-GaN HEMTs.

This paper proposes a novel p-GaN HEMT (P-HEMT) by clamping channel potential to improve breakdown voltage (BV) and threshold voltage (VTH) stability. The clamping channel potential for P-HEMT is achieved by a partially-recessed p-GaN layer (PR p-GaN layer). At high drain bias, the two-dimensional electron gas (2DEG) channel under the PR p-GaN layer is depleted to withstand the drain bias. Therefore, the channel potential at the drain-side of the p-GaN layer is clamped to improve BV and VTH stability. Compared with the conventional p-GaN HEMT (C-HEMT), simulation results show that the BV is improved by 120%, and the VTH stability induced by high drain bias is increased by 490% for the same on-resistance. In addition, the influence of the PR p-GaN layers' length, thickness, doping density on BV and VTH stability is analyzed. The proposed device can be a good reference to improve breakdown voltage and threshold voltage stability for short-channel power p-GaN HEMTs.

A Novel AlGaN/GaN Transient Voltage Suppression Diode with Bidirectional Clamp Capability.

This work proposes a novel AlGaN/GaN transient voltage suppression (TVS) diode (B-TVS-D) with bidirectional clamp capability, which consists of a small-size AlGaN/GaN monolithic bidirectional switch, two 2DEG-based current-limiting resistors (R1A/R1C, in parallel connection between the gate electrodes and the neighboring ohmic-contact electrodes (anode/cathode)), and a 2DEG-based proportional amplification resistor (R2, in parallel connection between two gate electrodes). It is demonstrated that the proposed B-TVS-D possesses a symmetrical triggering voltage (Vtrig) and a high secondary breakdown current (Is, over 8 A, corresponding to 12 kV human body model failure voltage) in different directional electrostatic discharge (ESD) events. The proposed diode can effectively enhance the electrostatic discharge robustness for the GaN-based power system. It is also verified that R1A/R1C and R2 have an important impact on Vtrig of the proposed B-TVS-D. Both the decrease in R2 and increase in R1A/R1C can lead to the decrease of Vtrig. In addition, the proposed B-TVS-D can be fabricated on the conventional p-GaN HEMT platform, making the ESD design of the GaN-based power system more convenient.

A Novel Bidirectional AlGaN/GaN ESD Protection Diode.

Despite the superior working properties, GaN-based HEMTs and systems are still confronted with the threat of a transient ESD event, especially for the vulnerable gate structure of the p-GaN or MOS HEMTs. Therefore, there is still an urgent need for a bidirectional ESD protection diode to improve the ESD robustness of a GaN power system. In this study, an AlGaN/GaN ESD protection diode with bidirectional clamp capability was proposed and investigated. Through the combination of two floating gate electrodes and two pF-grade capacitors connected in parallel between anode or cathode electrodes and the adjacent floating gate electrodes (CGA (CGC)), the proposed diode could be triggered by a required voltage and possesses a high secondary breakdown current (IS) in both forward and reverse transient ESD events. Based on the experimental verification, it was found that the bidirectional triggering voltages (Vtrig) and IS of the proposed diode were strongly related to CGA (CGC). With CGA (CGC) increasing from 5 pF to 25 pF, Vtrig and IS decreased from ~18 V to ~7 V and from ~7 A to ~3 A, respectively. The diode's high performance demonstrated a good reference for the ESD design of a GaN power system.

Laboratory indicators in COVID-19 and other pneumonias: Analysis for differential diagnosis and comparison of dynamic changes during 400-day follow-up.

BACKGROUND: COVID-19 is spreading rapidly all over the world, the patients' symptoms can be easily confused with other pneumonia types. Therefore, it is valuable to seek a laboratory differential diagnostic protocol of COVID-19 and other pneumonia types on admission, and to compare the dynamic changes in laboratory indicators during follow-up. METHODS: A total of 143 COVID-19, 143 bacterial pneumonia and 145 conventional viral pneumonia patients were included. The model group consisted of 140 COVID-19, 80 bacterial pneumonia and 60 conventional viral pneumonia patients, who were age and sex matched. We established a differential diagnostic model based on the laboratory results of the model group on admission via a nomogram, which was validated in an external validation group. We also compared the 400-day dynamic changes of the laboratory indicators among groups. RESULTS: LASSO regression and multivariate logistic regression showed that eosinophils (Eos), total protein (TP), prealbumin (PA), potassium (K), high-density lipoprotein cholesterol (HDLC), and low-density lipoprotein cholesterol (LDLC) could differentiate COVID-19 from other pneumonia types. The C-index of the nomogram model was 0.922. Applying the nomogram to the external validation group showed an area under the curve (AUC) of 0.902. The 400-day change trends of the laboratory indexes varied among subgroups divided by sex, age, oxygenation index (OI), and pathogen. CONCLUSION: The laboratory model was highly accurate at providing a new method to identify COVID-19 in pneumonia patients. The 400-day dynamic changes in laboratory indicators revealed that the recovery time of COVID-19 patients was not longer than that of other pneumonia types.

Lp-PLA2, a potential protector of lung cancer patients complicated with pleural effusion from lung diseases, proves effective for the diagnosis and pathological classification of lung cancer.

Abnormal lipid metabolism plays a crucial role in cancers, but few studies have investigated the relationship between lipoprotein-associated phospholipase A2 (Lp-PLA2) and lung cancer. In this study, 58 benign lung disease (LB) and 57 lung cancer (LC) patients complicated with pleural effusion (PE) were included, and their fasting serum and PE samples were collected. Results showed that serum Lp-PLA2 in the LC group was lower than that in the LB group, and other serum lipids were higher (P < 0.05). Tumor markers from serum and the PE samples of LC patients were higher than those in the LB group (P < 0.05). Serum prealbumin (PA) in LC patients was higher than that in the LB group, and serum C-reactive protein (CRP) and procalcitonin (PCT) were lower (P < 0.05). In the LC group, serum Lp-PLA2 concentration was positively correlated with serum triglyceride (TG), Lp (a), carbohydrate antigen 199 (CA199), nutritional markers, and Lp-PLA2 in PE and negatively correlated with serum high-density lipoprotein cholesterol (HDLC), Apolipoprotein A1 (APOA1), CRP, PCT, and alpha fetoprotein (AFP) and LDH in PE. The ROC curve showed that the cutoff level of serum Lp-PLA2 for diagnosing LC was 226.685 (U/L) (sensitivity: 0.632, specificity: 0.793), while the C-index of the nomogram model combined with serum Lp-PLA2, age, and gender was 0.750. In LC patients, the higher serum Lp-PLA2 indicated higher probability of adenocarcinoma and lower probability of squamous cell carcinoma (SCC). In conclusion, Lp-PLA2 may be a protective factor of lung cancer among lung disease patients complicated with pleural effusion, and it would facilitate the diagnosis and pathological classification of lung cancer.

The role of lymphocyte-monocyte ratio on axial spondyloarthritis diagnosis and sacroiliitis staging.

BACKGROUND: Axial spondyloarthritis (axial SpA) is a chronic inflammatory disorder could lead to disability due to the failure of timely treatment. The role of lymphocyte-to-monocyte ratio (LMR) in axial SpA remains unclear. The aim of this study was to investigate the role of LMR in axial SpA diagnosis, disease activity classification and sacroiliitis staging. METHODS: Seventy-eight axial SpA patients [51males and 27 females; mean age 41.0 (29-52) years] and 78 healthy controls (HCs) [55males and 23 females; mean age 40 (30-53) years] were enrolled in this study. The diagnosis of axial SpA was performed according to the New York criteria or the Assessment of Spondyloarthritis international Society (ASAS) classification criteria, whereas the staging of sacroiliitis in axial SpA patients was determined by X-ray examination. Comparisons of LMR levels between groups were performed using t test. Pearson or Spearman correlation analysis were used to assess correlations between LMR and other indicators. Receiver operating characteristic (ROC) curves were used to determine the role of LMR in the diagnosis of axial SpA. RESULTS: Higher neutrophil-to-lymphocyte ratio(NLR), red blood cell distribution width(RDW), platelet-to-lymphocyte ratio(PLR), mean platelet volume(MPV), erythrocyte sedimentation rate (ESR), and C-reactive protein(CRP) levels and lower red blood cell (RBC), hemoglobin (Hb), Hematocrit (Hct), LMR, alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBIL) and albumin/globulin (A/G) levels were noted in axial SpA patients compared to HCs. Positive correlations were observed between LMR and RBC, Hb, Hct and A/G, whereas negative correlations were found between LMR and NLR, PLR, AST, and TBIL (P < 0.05). ROC curves showed that the area under the curve (AUC) for LMR in the diagnosis of ankylosing spondylitis was 0.803 (95% CI = 0.734-0.872) with a sensitivity and specificity of 62.8 and 87.2%, respectively, and the AUC (95% CI) for the combination of ESR, CRP and LMR was 0.975 (0.948-1.000) with a sensitivity and specificity of 94.9 and 97.4%, respectively. LMR levels were lower (P < 0.05) and significant differences in LMR values were observed among different stages (P < 0.05). CONCLUSIONS: Our study suggested that LMR might be an important inflammatory marker to identify axial SpA and assess disease activity and X-ray stage of sacroiliitis.

Gold Enhanced Graphene-Based Photodetector on Optical Fiber with Ultrasensitivity over Near-Infrared Bands.

Graphene has been widely used in photodetectors; however its photoresponsivity is limited due to the intrinsic low absorption of graphene. To enhance the graphene absorption, a waveguide structure with an extended interaction length and plasmonic resonance with light field enhancement are often employed. However, the operation bandwidth is narrowed when this happens. Here, a novel graphene-based all-fiber photodetector (AFPD) was demonstrated with ultrahigh responsivity over a full near-infrared band. The AFPD benefits from the gold-enhanced absorption when an interdigitated Au electrode is fabricated onto a Graphene-PMMA film covered over a side-polished fiber (SFP). Interestingly, the AFPD shows a photoresponsivity of >1 × 104 A/W and an external quantum efficiency of >4.6 × 106% over a broadband region of 980-1620 nm. The proposed device provides a simple, low-cost, efficient, and robust way to detect optical fiber signals with intriguing capabilities in terms of distributed photodetection and on-line power monitoring, which is highly desirable for a fiber-optic communication system.

Dynamic changes in routine blood parameters of a severe COVID-19 case.

BACKGROUND: Novel coronavirus infectious disease (COVID-19) has been spreading worldwide, and tracking laboratory indexes during the diagnosis and treatment of patients with severe COVID-19 can provide a reference for patients in other countries and regions. METHODS: We closely tracked the epidemiological history, diagnosis and treatment process, as well as dynamic changes in routine blood indicators, of a severe COVID-19 patient who was hospitalized for 26 days. RESULTS: Our study found that the patient's condition worsened in the first week after admission, white blood cells (WBCs), neutrophils, lymphocytes, monocytes, eosinophils, red blood cells (RBCs), hemoglobin, neutrophil lymphocyte ratio (NLR), platelets (PLT) and platelet lymphocyte ratio (PLR) decreased. On the 7th day of admission, the levels of these cells decreased to their lowest values, though the red blood cell distribution width (RDW) and C-reactive protein (CRP) level remained at high values. From 8 to 14 days of admission, the patient's condition improved, hypoxemia was corrected, and mechanical ventilation was discontinued. The number of WBCs, neutrophils, monocytes, eosinophils and lymphocytes increased gradually, and the erythrocyte parameters stopped declining and stabilized in a certain range; CRP decreased rapidly. On the 20th day of admission, the nucleic acid test was negative, WBC, neutrophil, CRP, NLR and PLR decreased gradually, and monocyte, lymphocyte, and eosinophil counts increased. Although RBCs and hemoglobin (Hb) levels continued to decrease, RDW gradually increased, indicating the recovery of hematopoiesis. In addition, it should be noted that monocytes and eosinophils were at extremely low levels within 10 days after admission; the recovery time of eosinophils was approximately 12 days after admission, which was earlier than other parameters, which might be of great value in judging the progress of the disease. CONCLUSIONS: Dynamic changes in routine blood parameters might be helpful for the prognosis of COVID-19 patients and evaluation of the treatment effect.