Increase in the incidence of invasive fungal infections due to Volvariella Volvacea.

PURPOSE: We aimed to show the increasing incidence of invasive fungal infections due to Volvariella Volvacea in patients with immunosuppression. METHODS: We present a case of an invasive fungal infection caused by Volvariella volvacea, and summarize the clinical and pathological features based on this case and a review of the literature. RESULTS: A total of seven patients with IFIs due to Volvariella Volvacea have been reported in the literature. The majority of cases have been obtained between 2019 and 2022. Including our case, they all had acquired immunosuppression. The lung and brain were the most commonly affected organs. All eight of these patients received antifungal therapy, but five still died one to seven months after occurrences of IFIs. CONCLUSION: The incidence of invasive fungal infections due to Volvariella Volvacea is increasing in recent years. It mainly occurred in patients with immunosuppression, especially in patients with malignant hematological cancers, and increased mortality.

Metastasis of a basosquamous carcinoma arising in a nevus sebaceus.

Nevus sebaceus (NS) is a congenital hamartoma of skin structures including the epidermis, sweat sebaceous glands, and hair follicles. It is known that secondary tumors can occur in NS. However, secondary metastatic malignancies are rare. Basosquamous carcinoma (BSC) is an aggressive type of basal cell carcinoma (BCC) characterized by squamous differentiation. Herein, we report a case of metastatic BSC that developed in a 73-year-old male with NS. The clinical presentation of this patient was that of an ulcerative nodule developing in a longstanding plaque-like lesion consistent with NS. Histopathological examination revealed characteristic features of BCC with some areas of squamous differentiation in addition to the structure of a typical NS. Immunohistochemical expression of Ber-EP4, AE1/AE3, and epithelial membrane antigen helped to make the diagnosis of BSC.

Secondary Tumors Arising from Nevus Sebaceus: A Multicenter Collaborative Study and Literature Review.

BACKGROUND: Although various benign and malignant tumors can arise in nevus sebaceus (NS), the demographic and clinicopathological features of the secondary tumors vary among different published reports. The aim of this study was to obtain a better understanding of the features of tumors secondary to NS. METHODS: A multicenter study was performed by reviewing patients diagnosed with NS from the Dermatology Department of the First Affiliated Hospital of Chongqing Medical University and Qijiang Hospital of the First Affiliated Hospital of Chongqing Medical University from 2010 to 2022. A literature review of case series of secondary tumors arising in NS was also conducted. RESULTS: We retrospectively analyzed the literature on tumors secondary to NS published since 2000, with a total of 443 cases, and carefully studied cases of tumors arising in NS from multiple centers since 2010, with a total of 54 cases. There were 497 cases in this study; 90.3% were benign tumors (n = 449), and the rest were malignant tumors (9.7%, n = 48). Syringocystadenoma papilliferum was the most common benign tumor, followed by trichoblastoma and trichilemmoma. Basal cell carcinoma was the most common secondary malignant tumor to NS, followed by squamous cell carcinoma. Two of these cases developed metastasis. Secondary malignancies developed at an earlier age in Caucasians than in Hispanics and Asians. CONCLUSION: The present study is the largest analysis of tumors secondary to NS. Racial differences were seen in secondary tumors to NS and may contribute to healthcare disparities between races.

Diagnostic efficacy of anti-SARS-CoV-2 IgG/IgM test for COVID-19: A meta-analysis.

The serological testing of anti-SARS-CoV-2 immunoglobulin G (IgG) and/or IgM is widely used in the diagnosis of COVID-19. However, its diagnostic efficacy remains unclear. In this study, we searched for diagnostic studies from the Web of Science, PubMed, Embase, CNKI, and Wanfang databases to calculate the pooled diagnostic accuracy measures using bivariate random-effects model meta-analysis. As a result, 22 from a total of 1613 articles, including 2282 patients with SARS-CoV-2 and 1485 healthy persons or patients without SARS-CoV-2, were selected for a meta-analysis. Pooled sensitivity, specificity, and area under curve of the summary receiver operator curve (SROC) were: (a) 0.85 (95% confidence interval [CI]: 0.79-0.90), 0.99 (95% CI: 0.98-1.00), and 0.99 (95% CI: 0.97-0.99) for anti-SARS-CoV-2 IgG and (b) 0.74 (95% CI: 0.65-0.81), 0.99 (95% CI: 0.97-1.00), and 0.95 (95% CI: 0.93-0.97) for IgM. A subgroup analysis among detection methods indicated the sensitivity of IgG and IgM using enzyme-linked immunosorbent assay were slightly lower than those using gold immunochromatography assay (GICA) and chemiluminescence immunoassay (P > .05). These results showed that the detection of anti-SARS-CoV-2 IgG and IgM had high diagnostic efficiency to assist the diagnosis of SARS-CoV-2 infection. And, GICA might be used as the preferred method for its accuracy and simplicity.

The intrinsic microstructure of supramolecular hydrogels derived from α-cyclodextrin and pluronic F127: nanosheet building blocks and hierarchically self-assembled structures.

Supramolecular hydrogels derived from the self-assembly of α-cyclodextrin with pluronic F127 were found to be built up with polypseudorotaxane nanosheets with a thickness of 30-40 nm and possessed flower-like hierarchically assembled structures. The findings in this work could provide critical guidance for material design for biomedical purposes.

Laboratory findings of COVID-19: a systematic review and meta-analysis.

The Coronavirus Disease (COVID-19) pandemic first broke out in December 2019 in Wuhan, China, and has now spread worldwide. Laboratory findings have been only partially described in some observational studies. To date, more comprehensive systematic reviews of laboratory findings on COVID-19 are missing. We performed a systematic review with a meta-analysis to assess laboratory findings in patients with COVID-19. Observational studies from three databases were selected. We calculated pooled proportions and 95% confidence interval (95% CI) using the random-effects model meta-analysis. A total of 1106 articles were identified from PubMed, Web of Science, CNKI (China), and other sources. After screening, 28 and 7 studies were selected for a systematic review and a meta-analysis, respectively. Of the 4,663 patients included, the most prevalent laboratory finding was increased C-reactive protein (CRP; 73.6%, 95% CI 65.0-81.3%), followed by decreased albumin (62.9%, 95% CI 28.3-91.2%), increased erythrocyte sedimentation rate (61.2%, 95% CI 41.3-81.0%), decreased eosinophils (58.4%, 95% CI 46.5-69.8%), increased interleukin-6 (53.1%, 95% CI 36.0-70.0%), lymphopenia (47.9%, 95% CI 41.6-54.9%), and increased lactate dehydrogenase (LDH; 46.2%, 95% CI 37.9-54.7%). A meta-analysis of seven studies with 1905 patients showed that increased CRP (OR 3.0, 95% CI: 2.1-4.4), lymphopenia (OR 4.5, 95% CI: 3.3-6.0), and increased LDH (OR 6.7, 95% CI: 2.4-18.9) were significantly associated with severity. These results demonstrated that more attention is warranted when interpreting laboratory findings in patients with COVID-19. Patients with elevated CRP levels, lymphopenia, or elevated LDH require proper management and, if necessary, transfer to the intensive care unit.

Diagnostic Accuracy of Dermoscopy for Scabies.

The diagnostic accuracy of dermoscopy (DS) for scabies, a highly contagious parasitic disease, remains disputed. This study aimed to assess the diagnostic accuracy of DS in scabies, analyze the factors influencing DS, and explore its role in post-treatment evaluation. Patients with suspected scabies were randomly divided into 2 groups: 71 patients in the skin scraping (SS) group and 73 patients in the DS group. The diagnostic efficiencies of SS and DS in these groups were calculated. We also analyzed the influence of body part and investigator competence on the accuracy of DS. Then 16 body parts with typical signs of scabies were monitored by DS 2 and 4 day after sulfur ointment treatment. The sensitivity and specificity of DS were 98.3% and 88.5%, respectively. Hands, arms, and the abdomen had higher positivity rates than other body parts (P<0.001). The accuracy of dermatologists' interpretations of images negative for scabies in the intermediate- and high-level groups was higher than that in the low-level group (P<0.001). At follow-up, the mites were still visible on 43.8% to 62.5% of the skin lesions 2 and 4 day after sulfur ointment treatment. These results showed that DS could significantly increase the accuracy of diagnosing scabies owing to its high sensitivity and specificity. Therefore, it may be useful for monitoring clinical responses to anti-parasitic treatment.

LncRNA PVT1 regulates VEGFC through inhibiting miR-128 in bladder cancer cells.

Long noncoding RNA PVT1 is considered to be an oncogene in multiple cancers. Our previous studies indicated that PVT1 levels were higher in bladder cancer tissue and correlated with clinical progression and poor prognosis in bladder cancer patients. A bioinformatics analysis showed that PVT1 may regulate VEGFC expression through miR-128 as a competing endogenous RNA (ceRNA). In this study, we demonstrated that PVT1 expression levels affect the proliferation and migration ability of bladder cancer cells. Moreover, PVT1 knockdown significantly decreased the proliferation capacity of bladder cancer cells in nude mice. Luciferase assays and RNA-binding protein immunoprecipitation were performed to investigate the potential mechanism of ceRNAs in the regulation of PVT1 and VEGFC. The results showed that the increased number of PVT1 transcripts interacted directly with miR-128 to decrease miR-128 binding to the VEGFC 3'-untranslated region. This effect suppressed VEGFC mRNA degradation by miR-128. In conclusion, these results indicated that PVT1 might play a critical role in bladder cancer tumorigenesis via miR-218 and VEGFC. Therefore, PVT1 could be a new biomarker for bladder cancer diagnosis and therapy.

Carotid Artery-Related Perioperative Stroke Following Anterior Cervical Spine Surgery: A Series of 3 Cases and Literature Review.

BACKGROUND: Vascular complications following anterior cervical spine surgery are rare but potentially devastating. Complications associated with the carotid artery are even more disastrous but largely anecdotal, with no more than 4 reported cases. MATERIALS AND METHODS: We report 3 new cases of carotid artery-related perioperative stroke following anterior cervical spine surgery. All 3 patients had carotid artery atherosclerosis and the time of intraoperative carotid artery retraction was longer than 1 hour. One patient underwent hypotension during surgery. Risk factors as well as prevention and management protocols of carotid artery-related perioperative stroke based on the literature review and our clinical experience are discussed. CONCLUSIONS: Carotid artery-related perioperative stroke following anterior cervical spine surgery is extremely rare. Prolonged traction, carotid artery atherosclerosis, and intraoperative hypotension can produce cerebral hypoperfusion and cause ischemic stroke. Preoperative risk assessment, adequate perioperative manipulation, and postoperative management can minimize overall morbidity and mortality.

Comparison of retrograde flexible ureteroscopy and percutaneous nephrolithotomy in treating intermediatesize renal stones (2-3cm): a meta-analysis and systematic review.

PURPOSE: To systematically assess the effectiveness and safety of retrograde flexible ureteroscopy (FURS) versus percutaneous nephrolithotomy (PCNL) in treating intermediate-size renal stones (2-3cm). MATERIALS AND METHODS: PubMed, Ovid MEDLINE, Web of Science, Cochrane Central Register of Controlled Trials (CENTRAL) and EMBASE were researched to identify relevant studies up to May 2018. Article selection was performed through the search strategy based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses criteria. The Newcastle-Ottawa Scale was applied to assess the methodological quality of case-control studies. RESULTS: Six retrospective case-controlled trials were included for meta-analysis. The pooled results showed that PCNL was associated with a higher initial stone-free rate (SFR). After more complementary treatments, FURS provided a final SFR (OR: 1.69; 95% CI, 0.93-3.05; P = 0.08) comparable to that achieved by PCNL. PCNL was associated with a higher rate of overall intraoperative complications (OR: 1.48; 95% CI, 1.01-2.17; P = 0.04) and longer hospital stay (MD: 2.21 days; 95% CI, 1.11 to 3.30; P < 0.001). Subgroup analysis by Clavien-graded complication showed PCNL had significantly higher rates of minor complications (OR: 1.58; 95% CI, 1.04-2.41; P = 0.03). No significant difference was noted in major complications (OR: 1.14; 95% CI, 0.53-2.45; P = 0.73) or operative times (MD: -9.71 min; 95% CI, -22.02 to 2.60; P = 0.12). CONCLUSIONS: Multisession FURS is an effective and safe alternative to PCNL for the management of intermediate-size renal stones (2-3cm). It is advisable to balance the benefits and risks according to the individual characteristics of patients and to decide with patients by discussing the advantages and disadvantages of each procedure.

How Does PHEMA Pass through the Cavity of γ-CDs to Create Mismatched Overfit Polypseudorotaxanes?

A syndiotactic-rich PHEMA oligomer ( rr = 74%, DP = 29, PDI = 1.19) was synthesized and subsequently subjected to self-assembly with a varying amount of γ-CDs in its aqueous solution to create mismatched overfit polypseudorotaxanes (PPRs). The inclusion complexation proceeded in an obvious mismatched manner between the cavity of γ-CDs and the cross-sectional area of an incoming PHEMA chain. The 2D-NOESY NMR analysis provided direct evidence indicating that two adjacent pendant hydroxyethyl groups in PHEMA preferably adopt a curled conformation to pass through the cavity of γ-CDs, giving the PPRs characteristics of a mismatched overfit instead of a matched tight-fit crystal structure. The results suggested that the mutual adaption of pendant side chains of HEMA units with the cavity geometry of γ-CDs would play a dominant role in this unfavorable overfit inclusion complexation besides the size of γ-CDs and the stereoregularity of the PHEMA chain.

Rapidly Recoverable Thixotropic Hydrogels from the Racemate of Chiral OFm Monosubstituted Cyclo(Glu-Glu) Derivatives.

Both chiral OFm monosubstituted cyclo(l-Glu-l-Glu) and cyclo(d-Glu-d-Glu) display a robust gelation ability in a variety of organic solvents and water. In contrast to an individual enantiomer, their racemate can form rapidly recoverable thixotropic hydrogels with a remarkably shorter thixotropic recovery time. This unexpected thixotropic behavior is induced by the random arrangement of d- and l-enantiomers in the cell units, leading to the formation of "pseudoracemate", noncrystalline self-assemblies in the resulting 3D fibrous network.

Low-Molecular-Weight Organo- and Hydrogelators Based on Cyclo(l-Lys-l-Glu).

Four cyclo(l-Lys-l-Glu) derivatives (3-6) were synthesized from the coupling reaction of protecting l-lysine with l-glutamic acid followed by the cyclization, deprotection, and protection reactions. They can efficiently gelate a wide variety of organic solvents or water. Interestingly, a spontaneous chemical reaction proceeded in the organogel obtained from 3 in acetone exhibiting not only visual color alteration but also increasing mechanical strength with the progress of time due to the formation of Schiff base. Moreover, 6 bearing a carboxylic acid and Fmoc group displayed a robust hydrogelation capability in PBS solution. Transmission electron microscopy (TEM) and scanning electron microscopy (SEM) revealed the characteristic gelation morphologies of 3D fibrous network structures in the resulting organo- and hydrogels. FT-IR and fluorescence analyses indicated that the hydrogen bonding and π-π stacking play as major driving forces for the self-assembly of these cyclic dipeptides as low-molecular-weight gelators. X-ray diffraction (XRD) measurements and computer modeling provided information on the molecular packing model in the hydrogelation state of 6. A spontaneous chemical reaction proceeded in the organogel obtained from 3 in acetone exhibiting visual color alteration and increasing mechanical strength. 6 bearing an optimized balance of hydrophilicity to lipophilicity gave rise to a hydrogel in PBS with MGC at 1 mg/mL.

A case of fourth atlanto-axial facet joint: anatomical description.

PURPOSE: To report a rare fourth atlanto-axial joint. METHODS: A cadaveric specimen of a young male adult from occiput to C4 was dissected for anatomical study of craniocervical region. A true fourth atlanto-axial joint was confirmed. Its morphological characteristics were described. RESULTS: The fourth atlantoaxial joint is rarely seen. The possible embryogenesis is discussed. This case raises an anatomical possibility of a new variant in this region. CONCLUSIONS: A unique case with an anatomically proven fourth atlantoaxial joint is reported. This anomaly can lead to misdiagnosis. CT scan coupled with MRI can facilitate accurate diagnosis.

Experimental study on the construction of small three-dimensional tissue engineered grafts of electrospun poly-ε-caprolactone.

Studies on three-dimensional tissue engineered graft (3DTEG) have attracted great interest among researchers as they present a means to meet the pressing clinical demand for tissue engineering scaffolds. To explore the feasibility of 3DTEG, high porosity poly-ε-caprolactone (PCL) was obtained via the co-electrospinning of polyethylene glycol and PCL, and used to construct small-diameter poly-ε-caprolactone-lysine (PCL-LYS-H) scaffolds, whereby heparin was anchored to the scaffold surface by lysine groups. A variety of small-diameter 3DTEG models were constructed with different PCL layers and the mechanical properties of the resulting constructs were evaluated in order to select the best model for 3DTEGs. Bone marrow mononuclear cells were induced and differentiated to endothelial cells (ECs) and smooth muscle cells (SMCs). A 3DTEG (labeled '10-4%') was successfully produced by the dynamic co-culture of ECs on the PCL-LYS-H scaffolds and SMCs on PCL. The fluorescently labeled cells on the 3DTEG were subsequently observed by laser confocal microscopy, which showed that the ECs and SMCs were embedded in the 3DTEG. Nitric oxide and endothelial nitric oxide synthase assays showed that the ECs behaved normally in the 3DTEG. This study consequently provides a new thread to produce small-diameter tissue engineered grafts, with excellent mechanical properties, that are perfusable to vasculature and functional cells.

Self-assemblies of γ-CDs with pentablock copolymers PMA-PPO-PEO-PPO-PMA and endcapping via atom transfer radical polymerization of 2-methacryloyloxyethyl phosphorylcholine.

Pentablock copolymers PMA-PPO-PEO-PPO-PMA synthesized via atom transfer radical polymerization (ATRP) were self-assembled with varying amounts of γ-CDs to prepare poly(pseudorotaxanes) (PPRs). When the concentration of γ-CDs was lower, the central PEO segment served as a shell of the micelles and was preferentially bent to pass through the γ-CD cavity to construct double-chain-stranded tight-fit PPRs characterized by a channel-like crystal structure. With an increase in the amount of γ-CDs added, they began to accommodate the poly(methyl acrylate) (PMA) segments dissociated from the core of the micelles. When more γ-CDs were threaded and slipped over the segments, the γ-CDs were randomly distributed along the pentablock copolymer chain to generate single-chain-stranded loose-fit PPRs and showed no characteristic channel-like crystal structure. All the self-assembly processes of the pentablock copolymers resulted in the formation of hydrogels. After endcapping via in situ ATRP of 2-methacryloyloxyethyl phosphorylcholine (MPC), these single-chain-stranded loose-fit PPRs were transformed into conformational identical polyrotaxanes (PRs). The structures of the PPRs and PRs were characterized by means of (1)H NMR, GPC, (13)C CP/MAS NMR, 2D (1)H NOESY NMR, FTIR, WXRD, TGA and DSC analyses.