Poly(ionic liquid)s-Based Thermal-Responsive Microgel for Use as SERS Substrates with "ON-OFF" Switchable Effect.

A temperature-responsive surface-enhanced Raman scattering (SERS) substrate with "ON-OFF" switching based on poly(ionic liquid)s (PILs) block copolymer microgels have been designed and synthesized. The PIL units act as a joint component to anchor the gold nanoparticles (AuNPs) and analytes onto poly(N-isopropylacrylamide) (PNIPAm). This anchor allows the analytes to be fixed at the formed hot spots under temperature stimulus. Owing to the regulation of the PNIPAm segment, the SERS substrates exhibit excellent thermally responsive SERS activity with a reversible "ON-OFF" effect. Additionally, because of the anion exchange of PILs, microgels can introduce new analytes, which offers more flexibility for the system. The substrate shows excellent reversibility, controllability, and flexibility of SERS activity, which is expected to have a broad application in the field of practical SERS sensors.

Sample size calculation for multi-arm parallel design with restricted mean survival time.

With the recent advances in oncology treatment, restricted mean survival time (RMST) is increasingly being used to replace the routine approach based on hazard ratios in randomized controlled trials for time-to-event outcomes. While RMST has been widely applied in single-arm and two-arm designs, challenges still exist in comparing RMST in multi-arm trials with three or more groups. In particular, it is unclear in the literature how to compare more than one intervention simultaneously or perform multiple testing based on RMST, and sample size determination is a major obstacle to its penetration to practice. In this paper, we propose a novel method of designing multi-arm clinical trials with right-censored survival endpoint based on RMST that can be applied in both phase II/III settings using a global χ2 test as well as a modeling-based multiple comparison procedure. The framework provides a closed-form sample size formula built upon a multi-arm global test and a sample size determination procedure based on multiple-comparison in the phase II dose-finding study. The proposed method enjoys strong robustness and flexibility as it requires less a priori set-up than conventional work, and obtains a smaller sample size while achieving the target power. In the assessment of sample size, we also incorporate practical considerations, including the presence of non-proportional hazards and staggered patient entry. We evaluate the validity of our method through simulation studies under various scenarios. Finally, we demonstrate the accuracy and stability of our method by implementing it in the design of two real clinical trial examples.

Optimization of Extraction Process, Preliminary Characterization and Safety Study of Crude Polysaccharides from Morindae Officinalis Radix.

In this study, the hot water extraction process of crude polysaccharides from Morindae officinalis radix (cMORP) was conducted and optimized through a single-factor test and orthogonal experimental design. With the optimal extraction process (extraction temperature of 80 °C, extraction time of 2 h, liquid/solid ratio of 15 mL/g, and number of extraction of 1), the cMORP was obtained by the ethanol precipitation method. The chemical properties and preliminary characterization of the cMORP were analyzed by chemical or instrumental methods. Furthermore, to indicate a preliminary study on safety, a single oral dose of 5000 mg/kg body weight (BW) was administered orally to Kunming (KM) mice for acute toxicity, and the cMORP was administered orally to KM mice once a day at doses of 25, 50, and 100 mg/kg BW for 30 days. General behaviors, body weight variations, histopathology, relative organ weights, and hematological and serum biochemical parameters were observed and recorded. The results suggested there were no toxicologically significant changes. Based on the safety study, cMORP can be initially considered non-toxic with no acute oral toxicity up to 5000 mg/kg BW and safe at up to 100 mg/kg BW in KM mice for 30 days.

Double filtration plasmapheresis for children with different types of critical kidney diseases: a single-center retrospective cohort study.

Background: Double filtration plasmapheresis (DFPP) was initially used to facilitate the conduction of ABO-incompatible renal transplantation. The applicability of DFPP has recently expanded to cover the removal of various antibodies in adults with immune-mediated diseases. However, DFPP is seldom used in children, with few reports addressing its efficacy and safety in this population. This study aimed to explore the efficacy and adverse effects of DFPP for pediatric patients with renal indications. Methods: Children who received DFPP between December 2017 and December 2020 at Tongji Hospital were retrospectively studied, and sub-grouped for analysis according to the types of disease. All children received 3 to 6 DFPP sessions within 2 to 3 weeks, and were assessed for clinical outcomes according to glomerular filtration rate, proteinuria and extra-renal symptoms. Pre- and post-DFPP plasma were collected to measure the levels of pathogenic autoantibodies, immunoglobulins, fibrinogen, albumin, calcium, etc. In-hospital complications were also recorded. Results: Totally there were 10 children receiving 44 sessions of DFPP, including 2 males and 8 females, with a median age of 11.2 years old (5-13 years) and a median weight of 42.1 kg (20-59 kg). Five patients were treated for systemic lupus erythematosus (SLE), three patients for antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV), one for C3 glomerulopathy and one for ABO-incompatible renal transplantation. Plasma autoantibodies decreased substantially by 93% and 89% in those with SLE and AAV after the last session, respectively. Complete or partial responses were achieved in 80%, 33.3%, 100% and 100% of patients with SLE, AAV, C3 glomerulopathy, and ABO-incompatible renal transplantation, respectively. The proportion of cumulative IgG, fibrinogen, and albumin removal at the end of the last sessions were 58.8%, 67.69%, and 14.05% respectively. The removal of calcium, potassium and creatinine were not statistically significant. A few episodes (4.55%) of hypotension were observed when fresh frozen plasma was used as the replacement fluid, and no bleeding nor severe anaphylaxis was noted. Conclusions: The efficacy and safety of DFPP treatment in children with SLE, AAV, C3 glomerulopathy and ABO-incompatible renal transplantation were described in the present study. DFPP is proven to be a safe apheresis method for children weighing more than 20 kg.

Heteropolyacid Ionic Liquid-Based MCF: An Efficient Heterogeneous Catalyst for Oxidative Desulfurization of Fuel.

A new type of catalyst was synthesized by immobilizing heteropolyacid on ionic liquid-modified mesostructured cellular silica foam (denoted as MCF) and applied to the oxidative desulfurization of fuel. The surface morphology and structure of the catalyst were characterized by XRD, TEM, N2 adsorption-desorption, FT-IR, EDS and XPS analysis. The catalyst exhibited good stability and desulfurization for various sulfur-containing compounds in oxidative desulfurization. Heteropolyacid ionic liquid-based MCF solved the shortage of the amount of ionic liquid and difficult separation in the process of oxidative desulfurization. Meanwhile, MCF had a special three-dimensional structure that was not only highly conducive to mass transfer but also greatly increased catalytic active sites and significantly improved catalytic efficiency. Accordingly, the prepared catalyst of 1-butyl-3-methyl imidazolium phosphomolybdic acid-based MCF (denoted as [BMIM]3PMo12O40-based MCF) exhibited high desulfurization activity in an oxidative desulfurization system. The removal of dibenzothiophene could achieve levels of 100% in 90 min. Additionally, four sulfur-containing compounds could be removed completely under mild conditions. Due to the stability of the structure, sulfur removal efficiency still reached 99.8% after the catalyst was recycled six times.

Unified model-free interaction screening via CV-entropy filter.

For many practical high-dimensional problems, interactions have been increasingly found to play important roles beyond main effects. A representative example is gene-gene interaction. Joint analysis, which analyzes all interactions and main effects in a single model, can be seriously challenged by high dimensionality. For high-dimensional data analysis in general, marginal screening has been established as effective for reducing computational cost, increasing stability, and improving estimation/selection performance. Most of the existing marginal screening methods are designed for the analysis of main effects only. The existing screening methods for interaction analysis are often limited by making stringent model assumptions, lacking robustness, and/or requiring predictors to be continuous (and hence lacking flexibility). A unified marginal screening approach tailored to interaction analysis is developed, which can be applied to regression, classification, and survival analysis. Predictors are allowed to be continuous and discrete. The proposed approach is built on Coefficient of Variation (CV) filters based on information entropy. Statistical properties are rigorously established. It is shown that the CV filters are almost insensitive to the distribution tails of predictors, correlation structure among predictors, and sparsity level of signals. An efficient two-stage algorithm is developed to make the proposed approach scalable to ultrahigh-dimensional data. Simulations and the analysis of TCGA LUAD data further establish the practical superiority of the proposed approach.

Case report: A case of acquired von Willebrand syndrome as onset clinical presentation of systemic lupus erythematosus manifested as epistaxis and pulmonary hemorrhage.

Background: Acquired von Willebrand syndrome (AVWS) is a less common bleeding disorder, primarily manifested as mild to moderate mucocutaneous bleeding and laboratory tests are similar to hereditary von Willebrand disease (VWD). AVWS is secondary to other diseases, and systemic lupus erythematosus (SLE) is a relatively rare cause. Case presentation: We report a case of AVWS as onset clinical presentation of SLE manifested as epistaxis and pulmonary hemorrhage. A 13-year-old male child presented to the hospital with a six-month history of recurrent epistaxis and a one-month history of anemia. Routine blood tests demonstrated severe normocytic anemia and normal platelet count. Von Willebrand test revealed a significantly lower level. High-resolution chest computed tomography (CT) showed patchy ground glass opacities consistent with hemorrhagic changes. After ruling out the family history, the patient was diagnosed with AVWS. Additional tests confirmed positive antinuclear and anti-Sm antibodies. The underlying SLE was diagnosed and treated with methylprednisolone with disease recovery. Conclusion: We recommend screening for bleeding disorders in patients with recurrent epistaxis. AVWS should be considered when laboratory findings suggest hereditary von Willebrand disease without a personal or familial history of bleeding. In addition, the underlying disease should be explored.

Highly stable acetylcholinesterase electrochemical biosensor based on polymerized ionic liquids microgel for pesticides detection.

A highly stable electrochemical biosensor for pesticide detection was developed. For the first time polymeric ionic liquids (PILs) were introduced to construct an acetylcholinesterase (AChE) biosensor . AChE was entrapped in PILs microspheres through an emulsion polymerization reaction, where negatively charged Au nanoparticles (Au NPs) can be immobilized by the positively charged PILs, leading to improved catalytic performance. The results suggest that the positively charged PILs not only provide a biocompatible microenvironment around the enzyme molecule, stabilizing its biological activity and preventing its leakage, but also act as a modifiable interface allowing other components with electron transport properties to be loaded onto the polymer substrate, thus providing an efficient electron transport channel for the entrapped enzyme. More notably, when AChE was immobilized in a positively charged environment, the active site is closer to the electrode, promoting faster electron transfer. The detection limits of the constructed electrochemical biosensor AChE@PILs@Au NPs/GCE toward carbaryl and dichlorvos (DDVP) were 5.0 × 10-2 ng ml-1 and 3.9 × 10-2 ng ml-1, in a wide linear range of 6.3 × 10-2-8.8 × 102 ng ml-1 and 1.3 × 10-1-1.4 × 103 ng ml-1, respectively. More importantly, the biosensor has high thermal and storage stability, which facilitates rapid field analysis of fruits and vegetables in a variety of climates. In addition, the biosensor reported has good repeatability and selectivity and has high accuracy in the analysis of peaches, tap water, and other types of samples.

Ultrasound-Guided Modified Seldinger Placement of Tenckhoff Catheters in Pediatric Patients Undergoing Peritoneal Dialysis: Single Center Experience.

Minimally invasive peritoneal dialysis (PD) catheterization is increasingly common, and percutaneous PD catheters may be placed using a trocar or the Seldinger technique. There are few reports of pediatric percutaneous PD catheter insertion. We retrospectively compared the outcomes from percutaneous placement of Tenckhoff catheters using a modified Seldinger technique with catheter placement by open surgery. This single-center retrospective study compared 14 pediatric patients who received percutaneous PD catheter insertion using an ultrasound-guided modified Seldinger technique (August 2018-February 2021) with 10 patients who received open-surgical PD catheter insertion (2015-2018). Complications and catheter survival were evaluated. The overall technical success rate was 100%, but the Seldinger technique required less time (30 vs. 45 min) and smaller incisions (1.1 vs. 4.4 cm). The early complications in the Seldinger and control groups were bleeding (1 vs. 0), catheter dysfunction (1 vs. 1), abdominal pain (3 vs. 7), and exit leakage (0 vs. 1). In the Seldinger group, the median time from insertion to first use was 3 days, and the minimum follow-up was 6 months. Catheter survival at 6 months was 93% (Seldinger group) and 90% (open surgery group). The adoption of this technique at our institution led to a significant increase in the percentage of new pediatric dialysis patients commencing PD rather than hemodialysis. Collectively, the modified Seldinger technique described here was safe and feasible in pediatric patients. This approach is simpler and more rapid than open surgery, and reduces early complications and increases PD uptake.

Clinical and Renal Histology Findings and Different Responses to Induction Treatment Affecting the Long-Term Renal Outcomes of Children With ANCA-Associated Vasculitis: a Single-Center Cohort Analysis.

Introduction: Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) is relatively rare in children. This article aimed to analyze clinical and renal histology findings and different responses to induction treatment associated with the long-term renal outcomes in children with AAV in a single center. Methods: All pediatric patients with AAV admitted to Tongji Hospital from January 2002 to January 2021 were included in the study. The demographic, clinical, pathological, laboratory, and treatment data and outcomes were collected and analyzed to identify predictors associated with response to induction treatment and progression to end-stage renal disease (ESRD). Results: In total, 48 children with AAV were included in this cohort; 81.25% of them were women, and 91.7% were microscopic polyangiitis (MPA). Kidney involvement was found in 45 patients (93.75%). The most common histopathological subtype was crescentic form in this cohort according to Berden's classification. In total, 34 patients (70.8%) showed eGFR <60 ml/min/1.73 m2 at the time of diagnosis. Complete and partial remission was achieved in 8 patients (16.7%) and 19 patients (39.6%), respectively, following 6-month induction treatment. Half of the patients eventually progressed to ESRD at a mean time of (13.04 ± 15.83) months after diagnosis. The independent predictors of nonremission following induction treatment and progression to ESRD were baseline eGFR <60 ml/min/1.73 m2 and hypertension at diagnosis. Renal survival significantly decreased over time in patients with renal sclerotic subtypes or those with nonremission following induction treatment by Kaplan-Meier curve estimation. Conclusions: Our study demonstrates that women, MPA, and crescentic subtypes are predominant in pediatric AAV in China. Initial renal failure (eGFR <60 ml/min/1.73 m2), hypertension, sclerotic pathological subtype, and nonremission following induction treatment are predictive of long-term renal outcomes.

Noninvasive assessment of kidney dysfunction in children by using blood oxygenation level-dependent MRI and intravoxel incoherent motion diffusion-weighted imaging.

OBJECTIVES: To explore whether multiparametric approach including blood oxygenation level-dependent MRI (BOLD-MRI) and intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI) can be applied in the assessment of renal function in children with chronic kidney disease (CKD). MATERIALS AND METHODS: This prospective study included 74 children (CKD stage 1-3, 51; CKD stage 4-5, 12; healthy volunteers, 11) for renal MRI examinations including coronal T2WI, axial T1WI and T2WI, BOLD-MRI, and DWI sequences. We measured the renal cortex and medulla T2*, ADC, Dt, Dp, and fp values on BOLD and DWI images. Appropriate statistical methods were applied for comparing MRI-derived parameters among the three groups and calculating the correlation coefficients between MRI-derived parameters and clinical data. Receiver operating characteristic (ROC) curves were used to assess the diagnostic performance of MRI-derived parameters. RESULTS: There were significant differences in cortex T2*, ADC, Dt, fp and medulla T2*, ADC, Dt among the three groups. Cortex T2*, ADC, Dt, fp and medulla T2*, ADC, Dt had a trend: CKD stage 4-5 < CKD stage 1-3 < healthy volunteers. Cortex and medulla T2*, ADC, Dt were significantly correlated with eGFR, serum creatinine (Scr), cystatin C. In addition, cortex T2* and eGFR showed the highest correlation coefficient (r = 0.824, p < 0.001). Cortex Dt and medulla T2* were optimal parameters for differentiating healthy volunteers and CKD stage 1-3 or CKD stage 4-5 and CKD stage 1-3, respectively. CONCLUSIONS: BOLD-MRI and IVIM-DWI might be used as a feasible method for noninvasive assessment of renal function in children with CKD.

Case Report: Successful Treatment of Refractory Interstitial Lung Disease With Cyclosporine A and Pirfenidone in a Child With SLE.

Interstitial lung disease (ILD) as an initial manifestation of lupus is rare, especially in young children. Here, we report a case of a 3-year-old boy who presented with fever, shortness of breath, and facial erythema. Clinical examination suggested a diagnosis of active systemic lupus erythematosus (SLE) with butterfly rash, anemia, positive antinuclear antibody, positive anti-double-stranded DNA, and hypocomplementemia. On retrospective review of the patient's records, multiple chest computed tomography (CT) images showed non-specific interstitial pneumonia + organizing pneumonia pattern, with no further autoimmune work-up during the visit to a respiratory department. In our opinion, persistent interstitial pneumonia may be a clue to connective tissue disease. The patient received steroid treatment for 1 year, and the radiological and immunological resolution was noted. However, he still suffered from cough and dyspnea. After a 1-year follow-up, he was hospitalized again for SLE relapse. While continuing corticosteroid therapy, the patient was given combination therapy consisting of cyclosporine A (CsA) and monthly-pulse cyclophosphamide for 6 months, and decreased proteinuria was noted. However, the patient's respiratory symptoms and pulmonary radiologic findings did not improve significantly. With continued steroid therapy, the patient was started on a daily regimen of CsA and pirfenidone. Both drugs were sufficiently effective to allow gradual reduction of steroid dosage. After 2 years of treatment, marked improvements in symptoms, pulmonary function and chest CT images were observed. Our experience with this case emphasizes that prompt work-up for connective tissue disease (CTD) should be considered in young children with ILD, and pirfenidone might be a useful add-on therapy with immunosuppressive agents for refractory CTD-ILD in pediatric patients. Nevertheless, further clinical trials including larger numbers of patients need to assess the efficiency and safety of this combination therapy for refractory CTD-ILD.

Novel pathogenic OCRL mutations and genotype-phenotype analysis of Chinese children affected by oculocerebrorenal syndrome: two cases and a literature review.

BACKGROUND: Oculocerebrorenal syndrome of Lowe is a rare X-linked disorder characterized by congenital cataracts, mental retardation, and proximal tubulopathy. This condition is caused by a mutation of OCRL gene (located at chromosome Xq26.1), which encodes an inositol polyphosphate 5-phosphatase. CASE PRESENTATION: We identified two novel OCRL mutations in two unrelated Chinese boys, each with a severe phenotype of Lowe syndrome. A novel de novo deletion (hemizygous c.659_662delAGGG, p.E220Vfs*29) was present in patient 1 and a novel splicing mutation (hemizygous c.2257-2A > T) that was maternally inherited was present in patient 2. A renal biopsy in patient 2 indicated mild mesangial proliferative glomerulonephritis, mild focal mononuclear cells infiltration, and interstitial focal fibrosis. Moreover, renal expression of OCRL-1 protein in patient 2 was significantly reduced compared to a control patient with thin basement membrane disease. CONCLUSIONS: This study reports two novel OCRL variants associated with severe ocular and neurologic deficiency, despite only mild renal dysfunction. Based on our two patients and a literature review, the genotype-phenotype correlation of OCRL mutations with this severe phenotype of Lowe syndrome suggest a possible clustering of missense, deletion, and nonsense mutations in the 5-phosphatase domain and Rho-GAP domain in the Chinese population.

Ionic liquid-based liposome for selective SERS detection.

An ionic liquid (IL)-based liposome was utilized as a substrate to construct a SERS platform. The isotropy of the IL outer surface together with its ion-exchange property led to the array-like growth of Au nanoparticles (NPs), generating hot-spots and resulting in anionic probes being present on the hot-spot regions. The simultaneous strategy of enrichment and localization endowed the platform with ability to detect trace amounts of anionic probes.

[Blood supply of pulmonary metastases and its clinical significance].

BACKGROUND & OBJECTIVE: Interventional treatment has been widely applied to primary lung carcinoma, but seldom applied to pulmonary metastases because the blood supply of pulmonary metastases has rarely been investigated, and the present understanding is controversial. This study was to explore the correlation of the clinical value of bronchial arterial chemotherapeutic infusion (BAI) combined bronchial arterial embolization (BAE) to the blood supply of pulmonary metastases. METHODS: Bronchial artery angiography was performed on 33 patients with pulmonary metastases to assess the blood supply and the distribution of pulmonary metastases. BAI was performed on hypovascular nodules, and BAE was performed on hypervascular nodules. RESULTS: Of the 89 metastatic nodules in the lungs of 33 patients, 63 (70.8%) were located in the mid-medial zone, and 26 (29.3%) in the lateral region of the lung; 56 had abundant blood supply, and 33 had poor blood supply. The blood supply of pulmonary metastases was correlated to the location of metastatic nodules. Most nodules in the mid-medial region had abundant blood supply, while most nodules in the lateral region had poor or had no blood supply (P<0.01). The blood supply of bronchial artery had no correlation to the volume of metastatic nodule (P>0.05). The curative efficacy of BAI and BAE was correlated to the blood supply of bronchial artery. The response rate was significantly higher in the hypervascular nodules treated with BAE than in the hypovascular nodules treated with BAI (71.4% vs. 42.4%, P<0.01). Most pulmonary metastases of hepatic cancer were hypervascular and the lipiodol deposited well in the nodules; during the follow-up, the nodules shrunk significantly and kept stable. CONCLUSIONS: Bronchial artery is the major feeding artery of pulmonary metastases. BAI and BAE are effective in treating pulmonary metastases with abundant blood supply.