[Spatial and temporal distribution and predictive value of chest CT scoring in patients with COVID-19]

Objective: To explore a modified CT scoring system, its feasibility for disease severity evaluation and its predictive value in coronavirus disease 2019 (COVID-19) patients. Methods: This study was a multi-center retrospective cohort study. Patients confirmed with COVID-19 were recruited in three medical centers located in Beijing, Wuhan and Nanchang from January 27, 2020 to March 8, 2020. Demographics, clinical data, and CT images were collected. CT were analyzed by two emergency physicians of more than ten years' work experience independently through a modified scoring system. Final score was determined by average score from the two reviewers if consensus was not reached. The lung was divided into 6 zones (upper, middle, and lower on both sides) by the level of trachea carina and the level of lower pulmonary veins. The target lesion types included ground-glass opacity (GGO), consolidation, overall lung involvement, and crazy-paving pattern. Bronchiectasis, cavity, pleural effusion, etc., were not included in CT reading and analysis because of low incidence. The reviewers evaluated the extent of the targeted patterns (GGO, consolidation) and overall affected lung parenchyma for each zone, using Likert scale, ranging from 0-4 (0=absent; 1=1%-25%; 2=26%-50%; 3=51%-75%; 4=76%-100%). Thus, GGO score, consolidation score, and overall lung involvement score were sum of 6 zones ranging from 0-24. For crazy-paving pattern, it was only coded as absent or present (0 or 1) for each zone and therefore ranging from 0-6. Results: A total of 197 patients from 3 medical centers and 522 CT scans entered final analysis. The median age of the patients was 64 years, and 54.8% were male. There were 76(38.8%) patients had hypertension and 30(15.3%) patients had diabetes mellitus. There were 75 of the patients classified as moderate cases, as well as 95 severe cases and 27 critical cases. As initial symptom, dry cough occurred in 170 patients, 134 patients had fever, and 125 patients had dyspnea. Reparatory rate, oxygen saturation, lymphocyte count and CURB 65 score on admission day varied among patients with different disease severity scale. There were 50 of the patients suffered from deterioration during hospital stay. The median time consumed for each CT by clinicians was 86.5 seconds. Cronbach's alpha for GGO, consolidation, crazy-paving pattern, and overall lung involvement between two clinicians were 0.809, 0.712, 0.678, and 0.906, respectively, showing good or excellent inter-rater correlation. There were 193 (98.0%) patients had GGO, 147 (74.6%) had consolidation, and 126(64.0%) had crazy-paving pattern throughout clinical course. Bilateral lung involvement was observed in 183(92.9%) patients. Median time of interval for CT scan in our study was 7 days so that the whole clinical course was divided into stages by week for further analysis. From the second week on, the CT scores of various types of lesions in severe or critically patients were higher than those of moderate cases. After the fifth week, the course of disease entered the recovery period. The CT score of the upper lung zones was lower than that of other zones in moderate and severe cases. Similar distribution was not observed in critical patients. For moderate cases, the ground glass opacity score at the second week had predictive value for the escalation of the severity classification during hospitalization. The area under the receiver operating characteristic curve was 0.849, the best cut-off value was 5 points, with sensitivity of 84.2% and specificity of 75.0%. Conclusions: It is feasible for clinicians to use the modified semi-quantitative CT scoring system to evaluate patients with COVID-19. Severe/critical patients had higher scores for ground glass opacity, consolidation, crazy-paving pattern, and overall lung involvement than moderate cases. The ground glass opacity score in the second week had an optimal predictive value for escalation of disease severity during hospitalization in moderate patients on admission. The frequency of CT scan should be reduced after entering the recovery stage.

H3K27M mutant diffuse midline glioma: a case report

OBJECTIVE

Diffuse midline glioma with H3K27M mutation is a new tumor type of WHO central nervous system tumor classification. It often occurs in the midline structure and usually has a poor prognosis.

CASE REPORT

A 38-year-old male patient presented with 2 years history of right limb with facial numbness, tumors in the left thalamic region and lateral ventricle was detected by imaging. The patient underwent the first surgery.

RESULTS

The pathological examination results: Glioblastoma. He recovered well after surgery and received a total of 30 times of radiotherapy and temozolomide for one year. Fourteen months later, tumours were observed in the left thalamic region and left parieto-occipital lobe, the patient underwent the second operation. Immunohistochemistry showed: H3K27M(+). He experienced limitation of right limb movement after surgery and started taking oral apatinib 250 mg qd. After one-year, multiple tumors were found in the left brainstem, bilateral ventricles, bilateral basal ganglia, etc. The patient was given radiotherapy 7 times and then took apatinib 250 mg qd. Now the patient is still alive.

CONCLUSIONS

H3K27M mutant diffuse midline glioma is characterized by diffuse infiltrative growth. Its pathological classification is diverse, imaging features lack specificity, and prognostic factors are complex. Traditional radiochemotherapy has limited effects, molecular targeted therapy, especially intervention of epigenetic regulation is being explored.

Performance demonstration of vacuum microwave components critical for the operation of the ITER low-field side reflectometer

Final design studies in preparation for manufacturing have been performed for functional components of the vacuum portion of the ITER Low-Field Side Reflectometer (LFSR). These components consist of an antenna array, electron cyclotron heating (ECH) protection mirrors, phase calibration mirrors, and vacuum windows. Evaluation of these components was conducted at the LFSR test facility and DIII-D. The antenna array consists of six corrugated-waveguide antennas for simultaneous profile, fluctuation, and Doppler measurements. A diffraction grating, incorporated into the plasma-facing miter bend, provides protection of sensitive components from stray ECH at 170 GHz. For in situ phase calibration of the LFSR profile reflectometer, an embossed mirror is incorporated into the adjacent miter bend. Measurements of the radiated beam profile indicate that these components have a small, acceptable effect on mode conversion and beam quality. Baseline transmission characteristics of the dual-disk vacuum window are obtained and are used to guide ongoing developments. Preliminary simulations indicate that a surface-relief structure on the window surfaces can greatly improve transmission. The workability of real-time phase measurements was demonstrated on the DIII-D profile reflectometer. The new automated real-time analysis agrees well with the standard post-processing routine.

XPG gene polymorphisms and glioma susceptibility: a two-centre case-control study

Background: Glioma, the most common tumour in children next to leukaemia, is difficult to treat, with a poor prognosis and high recurrence rate. Xeroderma pigmentosum group G (XPG) plays a key role in the nucleotide excision repair pathway, which may modulate individual susceptibility to developing cancer. We hypothesized links between XPG variants and glioma in children.Methods: We tested our hypothesis in a study comparing 171 glioma cases with 228 age and sex matched controls, determining XPG polymorphisms rs2094258 C > T, rs751402 C > T, rs2296147 T > C, rs1047768 T > C, rs873601 G > A by standard molecular genetic methods.Results: rs2094258 C > T was associated with a decreased glioma risk, but carrying the rs1047768 C or rs873601 A allele brought an increased risk. Subjects carrying 5 risk genotypes had a significantly increased glioma risk at an adjusted odds ratio of 1.97 (95% confidence Interval 1.26-3.08)(p = 0.003) when compared with those carrying 0-4 risk genotypes. Furthermore, children with 5 risk genotypes had a higher glioma risk when aged >60 months, were more likely to be male, and with subtypes of astrocytic tumours, and low-grade clinical stage, when compared to those with 0-4 risk genotypes. Preliminary functional exploration suggested that rs2094258 is linked with the expression of its surrounding genes in the expression quantitative trait locus analysis.Conclusion: Certain variants of XPG are risk factors for paediatric glioma, and so may be useful in early diagnosis.

The effect of in-hospital high-dose vs. low-dose intensive statin in patients with non-ST segment elevation acute coronary syndrome

Background

Statins remain a standard treatment for acute coronary syndrome (ACS) patients. We aimed to determine the association between different dosages of in-hospital statins and the prognoses among patients receiving percutaneous coronary intervention (PCI).

Methods

NSTE-ACS patients were retrospectively enrolled from January 2010 to December 2014 from five centres in China. Patients receiving either atorvastatin or rosuvastatin during their hospitalizations were included. All the patients were categorized into high-dose statin group (40mg atorvastatin or 20mg rosuvastatin) or low-dose statin group (20mg atorvastatin or 10mg rosuvastatin). In-hospital events and long-term all-cause death was recorded.

Results

Of the 7,008 patients included in the study, 5,248 received low-dose intensive statin (mean age: 64.28±10.39; female: 25.2%), and 1,760 received high-dose intensive statin (mean age: 63.68±10.59; female: 23.1%). There was no significant difference in in-hospital all-cause death between the two groups (adjusted OR, 1.27; P=0.665). All-cause death was similar between the two groups during the long-term follow-up period (30-day: adjusted HR, 1.28; P=0.571; 3-year: adjusted HR, 0.83; P=0.082). However, there was a robust association between the high-dose statin and the reduction in in-hospital dialysis (adjusted OR, 0.11; P=0.030).

Conclusions

The in-hospital high-dose intensive statin is not associated with lower risks of in-hospital or follow-up all-cause death in NSTE-ACS patients undergoing PCI. Considering the robust beneficial effect of in-hospital dialysis, an individualized high-dose intensive statin can be rational in specified populations.

Univariate and multivariate analyses

Funding Acknowledgement

Type of funding source: Public grant(s) – National budget only. Main funding source(s): The Science and Technology Planning Project of Guangzhou City athe China Youth Research Funding

[Transnasal endoscopic surgery of choanal atresia after radiotherapy for nasopharyngeal carcinoma]

Objective: To discuss the effect of endoscopic dilatation and plasty for choanal atresia after radiotherapy for nasopharyngeal carcinoma. Methods: Nineteen patients with choanal atresia who were admitted to the Department of Otorhinolaryngology Head and Neck Surgery of the First Affiliated Hospital of Nanchang University from Jan. 2011 to Dec. 2018 were reviewed, with 12 males and 7 females aging from 33 to 59 years old. All of the patients had a history of radiotherapy for nasopharyngeal carcinoma and were confirmed by electronic nasopharyngoscope and nasopharyngeal imaging. Among 19 patients, there were 3 cases of unilateral occlusion and 16 cases with bilateral atresia, and all of them were membranous atresia. All patients received the transnasal endoscopic surgery of resecting partial vomer bone while trying to keep normal mucosa tissues and using the septonasal mucoperiosteal flap to repair under general anesthesia. One week after operation, the patients were told to do physiological saline nasal irrigation and received regular clean and observation under endoscope. Descriptive statistical method was used to analyze the outcome. Results: The patients were followed up for 1 year postoperatively by electronic nasopharyngoscopic examination. There was no failure case in all the 19 patients including 16 patients with a wide choana and 3 patients had narrowing of the choana (<50%), with adequate and satisfactory airway. Conclusions: Transnasal endoscopic surgery was an effective treatment for choanal atresia after radiotherapy for nasopharyngeal carcinoma. Application of septonasal mucoperiosteal flap for repairing nasal and nasopharyngeal mucosa would avoid recurrence.

Hydrogen peroxide assisted photorelease of an anthraquinone-based ligand from [Ru(2,2'-bipyridine)2(9,10-dioxo-9,10-dihydroanthracen-1-olate)]Cl in aqueous solution

A new class of light-activated ruthenium(ii) complex was designed as a potential blocker of biological functioning, especially for targeting redox reactions within mitochondria under light activation. Based on our concepts the complex [Ru(bipy)2(1-hydroxyanthra-9,10 quinone)]Cl (RU1) was prepared and studied to understand the preliminary reaction mechanisms and its excited state behaviour through a series of stability tests, electrochemistry, UV-Visible kinetics and femtosecond transient absorption spectroscopy experiments. Under white light in the presence of H2O2 two different reactions (fast and slow) appear to take place. The complex loses the quinone-based ligand and a resulting Ru(iii) or Ru(v) species is produced. The complex RU1 shows potential to consume H2O2 from the one carbon metabolism in mitochondria, and hence may cut the energy cycle pathway of tumor cells.

Identification of risk factors for falls in postmenopausal women: a systematic review and meta-analysis

The purpose of this study was to identify risk factors for falls in postmenopausal women and provide evidence for the primary prevention of falls in postmenopausal women. The protocol for this meta-analysis is registered with PROSPERO (CRD42020170927). We searched PubMed, the Cochrane Library and EMBASE for observational studies on the risk factors for falls in postmenopausal women. Review Manager 5.3 was used to calculate the relative risk (RR) or weighted mean difference (WMD) of potential risk factors related to falls. STATA 14.0 was used for the quantitative evaluation of publication bias. Eleven studies with 42,429 patients from 7 countries were included. The main risk factors for falls in postmenopausal women were patient sociodemographic risk factors (age: WMD = 0.37, 95% CI 0.07 to 0.68; body weight: WMD = 0.88, 95% CI 0.56 to 1.12; BMI: WMD = 0.34, 95% CI 0.21 to 0.46; exercise: RR = 0.97, 95% CI 0.94 to 0.99; and FES-I: WMD = 6.60, 95% CI 0.72 to 12.47) and medical risk factors (dietary calcium intake: WMD = - 16.91, 95% CI - 25.80 to - 8.01; previous fracture history: RR = 1.21, 95% CI 1.13 to 1.29; previous falls: RR = 2.02, 95% CI 1.91 to 2.14; number of diseases, ˃ 2: RR = 1.17, 95% CI 1.11 to 1.23; and number of reported chronic health disorders: WMD = 0.30, 95% CI 0.10 to 0.49). Knowledge of the many risk factors associated with falls in postmenopausal women can aid in fall prevention. However, we cannot rule out some additional potential risk factors (age at the onset of menopause, years since last menstruation, hormone therapy and BMD) that need further clinical research.

Study on the function and mechanism of long non-coding RNA DMTF1v4 in the occurrence of colon cancer

OBJECTIVE

To investigate the expression of long non-coding RNA (lncRNA) DMTF1v4 in colon cancer, and the relationship between its expression and disease occurrence.

MATERIALS AND METHODS

Human colon cancer tissues and para-carcinoma tissues were harvested. The expression of lncRNA DMTF1v4 was measured by semi-quantitative PCR. The expression of DMTF1v4 in HT-29 colon cancer cells was downregulated using siRNA, and the effect of its downregulation on cell growth was determined by MTT assay and plate clone assay. The effect of DMTF1v4 downregulation on colon cancer cell migration was determined using a transwell assay and scratch wound assay. The effect of DMTF1v4 on colon cancer cell apoptosis was determined using Annexin V/PI double-staining. The changes in p-ERK, p-JNK, and p-p38 were measured by Western blot. HT-29 cells with downregulated DMTF1v4 expression were used to establish the subcutaneous heterotopic transplantation tumor model in nude mice to study the effect of DMTF1v4 on tumor growth in animals.

RESULTS

Compared with para-carcinoma tissue, lncRNA DMTF1v4 in colon cancer tissue was highly expressed (p<0.001). Downregulating lncRNA DMTF1v4 in HT-29 cells showed that lncRNA DMTF1v4 promotes cell proliferation and migration, and suppresses apoptosis (p<0.05). The effect of lncRNA DMTF1v4 on the ERK/MAPK signaling pathway was evaluated. The expression of p-ERK, p-JNK, and p-p38 was increased significantly compared with the control group (p<0.01). The effect of downregulating DMTF1v4 on tumor growth in animals showed that tumor growth in nude mice was decreased, and the expression of apoptosis-related proteins was increased (p<0.01).

CONCLUSIONS

The expression of lncRNA DMTF1v4 is elevated in colon cancer tissues; lncRNA DMTF1v4 promotes colon cancer cell proliferation and migration, and inhibits apoptosis by downregulating the expression of p-ERK, p-JNK, and p-p38, thus affecting the progression of colon cancer. This will provide a basis for the development of new clinical treatments for colon cancer.

An unprecedented oxidised julolidine-BODIPY conjugate and its application in real-time ratiometric fluorescence sensing of sulfite

Reaction of a julolidine-based BODIPY compound with silver(i) ions in the presence of white light produced the oxidised julolidine version (OXJUL) containing a quaternary nitrogen. The oxidation of one ring at the julolidine site is highly unusual and there is no other reported literature example. The fluorescence maximum of OXJUL is altered from 648 nm to 608 nm by the addition of an aqueous solution of Na2SO3 over several minutes. In the presence of a large excess of sulfite a further slower reaction is observed which further shifts the emission maximum to 544 nm. The alterations form the basis of a real-time ratiometric sensor for sulfite and its detection in a white wine.

The influence of antibiotics on gut bacteria diversity associated with laboratory-reared Bactrocera dorsalis

The oriental fruit fly Bactrocera dorsalis (Hendel) is a destructive insect pest of a wide range of fruit crops. Commensal bacteria play a very important part in the development, reproduction, and fitness of their host fruit fly. Uncovering the function of gut bacteria has become a worldwide quest. Using antibiotics to remove gut bacteria is a common method to investigate gut bacteria function. In the present study, three types of antibiotics (tetracycline, ampicillin, and streptomycin), each with four different concentrations, were used to test their effect on the gut bacteria diversity of laboratory-reared B. dorsalis. Combined antibiotics can change bacteria diversity, including cultivable and uncultivable bacteria, for both male and female adult flies. Secondary bacteria became the dominant population in female and male adult flies with the decrease in normally predominant bacteria. However, in larvae, only the predominant bacteria decreased, the bacteria diversity did not change a lot, likely because of the short acting time of the antibiotics. The bacteria diversity did not differ among fruit fly treatments with antibiotics of different concentrations. This study showed the dynamic changes of gut bacterial diversity in antibiotics-treated flies, and provides a foundation for research on the function of gut bacteria of the oriental fruit fly.

Rational design of spontaneous reactions for protecting porous lithium electrodes in lithium-sulfur batteries

A rechargeable lithium anode requires a porous structure for a high capacity, and a stable electrode/electrolyte interface against dendrite formation and polysulfide crossover when used in a lithium-sulfur battery. Here, we design two simple steps of spontaneous reactions for protecting porous lithium electrodes. First, a reaction between molten lithium and sulfur-impregnated carbon nanofiber forms a fibrous network with a lithium shell and a carbon core. Second, we coat the surface of this porous lithium electrode with a composite of lithium bismuth alloys and lithium fluoride through another spontaneous reaction between lithium and bismuth trifluoride, solvated with phosphorous pentasulfide, which also polymerizes with lithium sulfide residual in the electrode to form a solid electrolyte layer. This protected porous lithium electrode enables stable operation of a lithium-sulfur battery with a sulfur loading of 10.2 mg cm-2 at 6.0 mA cm-2 for 200 cycles.

Retraction Note: circRNA_100290 plays a role in oral cancer by functioning as a sponge of the miR-29 family

The Editors and Publisher have agreed to retract the above paper following a request from the authors.

Clinical study of the radiotherapy with EDGE accelerator in the treatment of the moderate and severe thyroid associated ophthalmopathy

OBJECTIVE

To explore the short-term efficacy, acute complications and response factors after the radiotherapy with EDGE accelerator in patients with moderate and severe thyroid-associated ophthalmopathy (TAO).

PATIENTS AND METHODS

A total of 68 patients with moderate and severe TAO who received the radiotherapy with EDGE accelerator between August 1st, 2017 and May 1st, 2011 were enrolled in the present study. The clinical data were collected, and the efficacy and acute complications were followed up, and the response factors were analyzed.

RESULTS

Sixty-eight patients (136 eyes) were followed up for 6 months after radiotherapy. The total score after radiotherapy was significantly lower compared to that before the therapy (p<0.05), and the effective rate was 75.74%. After the radiotherapy, the patient's exophthalmia, soft tissue involvement, eye external muscle involvement, corneal involvement, decreased vision and diplopia, tearing and eyelid pain have improved. Acute complications included increased local inflammation, hair loss, pigmentation and xerophthalmias. In addition, multivariate logistic regression analysis demonstrated that thyroid hormone level was the independent factor for the response to the radiotherapy.

CONCLUSIONS

For patients with moderate and severe TAO, radiotherapy with EDGE accelerator is a safe and effective treatment option. Maintaining normal thyroid hormone level can improve the effective rate of radiotherapy.