Li3PO4-Enriched SEI on Graphite Anode Boosts Li+ De-Solvation Enabling Fast-Charging and Low-Temperature Lithium-Ion Batteries

Li+ de-solvation at solid-electrolyte interphase (SEI)-electrolyte interface stands as a pivotal step that imposes limitations on the fast-charging capability and low-temperature performance of lithium-ion batteries (LIBs). Unraveling the contributions of key constituents in the SEI that facilitate Li+ de-solvation and deciphering their mechanisms, as a design principle for the interfacial structure of anode materials, is still a challenge. Herein, we conducted a systematic exploration of the influence exerted by various inorganic components (Li2CO3, LiF, Li3PO4) found in the SEI on their role in promoting the Li+ de-solvation. The findings highlight that Li3PO4-enriched SEI effectively reduces the de-solvation energy due to its ability to attenuate the Li+-solvent interaction, thereby expediting the de-solvation process. Building on this, we engineer Li3PO4 interphase on graphite (LPO-Gr) anode via a simple solid-phase coating, facilitating the Li+ de-solvation and building an inorganic-rich SEI, resulting in accelerated Li+ transport crossing the electrode interfaces and interphases. Full cells using the LPO-Gr anode can replenish its 80 % capacity in 6.5 minutes, while still retaining 70 % of the room temperature capacity even at -20 °C. Our strategy establishes connection between the de-solvation characteristics of the SEI components and the interfacial structure design of anode materials for high performance LIBs.

Efficacy of treatment of equine anhidrosis with acupuncture and Chinese herbs is low but higher in treated horses compared with placebo

OBJECTIVE

To assess the therapeutic efficacy of acupuncture in combination with Chinese herbs for treatment of horses affected with anhidrosis.

ANIMALS

44 horses affected with anhidrosis for up to 3 years' duration were enrolled. Inclusion required both compatible clinical signs and results of a quantitative intradermal terbutaline sweat test.

METHODS

Study horses were randomly allocated into 2 groups. Group 1 (n = 19) was treated with daily Chinese herbs and 4 weekly acupuncture sessions. Group 2 (n = 25) was given daily hay powder as a placebo and 4 weekly sham acupuncture sessions. Horses were tested by quantitative intradermal terbutaline sweat test within 2 days after treatment completion and again 4 weeks following treatment.

RESULTS

Terbutaline-induced sweat responses (mg) were not different between groups within 2 days and 4 weeks after treatment. Two days after treatment, ratios of sweat responses (compared to baseline) were higher (P < .05) in the treatment group compared to the placebo group at terbutaline concentrations of 1.0, 100, and 1,000 µg/mL. The number of horses responding to treatment was higher in the treatment group (5/19 [26%]), compared to horses in the placebo group (1/25 [4%]) for 1 of 5 terbutaline concentrations 2 days (10 µg/mL) or 4 weeks (0.1 µg/mL) after treatment.

CLINICAL RELEVANCE

Ratios of sweat responses were higher in treatment horses 2 days after treatment, compared to baseline, but not 4 weeks later. The efficacy of a traditional Chinese veterinary medicine protocol for anhidrosis treatment with acupuncture and Chinese herbs was low but higher in treated horses compared with placebo.

[Epidemiological characteristics of human respiratory syncytial virus (HRSV) among acute respiratory infection (ARI) cases in 16 provinces of China from 2009 to 2023]

Objective: To understand the epidemiological characteristics of human respiratory syncytial virus (HRSV) among acute respiratory infection (ARI) cases in 16 provinces of China from 2009 to 2023. Methods: The data of this study were collected from the ARI surveillance data from 16 provinces in China from 2009 to 2023, with a total of 28 278 ARI cases included in the study. The clinical specimens from ARI cases were screened for HRSV nucleic acid from 2009 to 2023, and differences in virus detection rates among cases of different age groups, regions, and months were analyzed. Results: A total of 28 278 ARI cases were enrolled from January 2009 to September 2023. The age of the cases ranged from<1 month to 112 years, and the age M (Q1, Q3) was 3 years (1 year, 9 years). Among them, 3 062 cases were positive for HRSV nucleic acid, with a total detection rate of 10.83%. From 2009 to 2019, the detection rate of HRSV was 9.33%, and the virus was mainly prevalent in winter and spring. During the Corona Virus Disease 2019 (COVID-19) pandemic, the detection rate of HRSV fluctuated between 6.32% and 18.67%. There was no traditional winter epidemic peak of HRSV from the end of 2022 to the beginning of 2023, and an anti-seasonal epidemic of HRSV occurred from April to May 2023. About 87.95% (2 693/3 062) of positive cases were children under 5 years old, and the difference in the detection rate of HRSV among different age groups was statistically significant (P<0.001), showing a decreasing trend of HRSV detection rate with the increase of age (P<0.001). Among them, the HRSV detection rate (25.69%) was highest in children under 6 months. Compared with 2009-2019, the ranking of HRSV detection rates in different age groups changed from high to low between 2020 and 2023, with the age M (Q1, Q3) of HRSV positive cases increasing from 1 year (6 months, 3 years) to 2 years (11 months, 3 years). Conclusion: Through 15 years of continuous HRSV surveillance analysis, children under 5 years old, especially infants under 6 months old, are the main high-risk population for HRSV infection. During the COVID-19 pandemic, the prevalence and patterns of HRSV in China have changed.

Breaking Low-Strain and Deep-Potassiation Trade-Off in Alloy Anodes via Bonding Modulation for High-Performance K-Ion Batteries

Alloy anode materials have garnered unprecedented attention for potassium storage due to their high theoretical capacity. However, the substantial structural strain associated with deep potassiation results in serious electrode fragmentation and inadequate K-alloying reactions. Effectively reconciling the trade-off between low-strain and deep-potassiation in alloy anodes poses a considerable challenge due to the larger size of K-ions compared to Li/Na-ions. In this study, we propose a chemical bonding modulation strategy through single-atom modification to address the volume expansion of alloy anodes during potassiation. Using black phosphorus (BP) as a representative and generalizing to other alloy anodes, we established a robust P-S covalent bonding network via sulfur doping. This network exhibits sustained stability across discharge-charge cycles, elevating the modulus of K-P compounds by 74%, effectively withstanding the high strain induced by the potassiation process. Additionally, the bonding modulation reduces the formation energies of potassium phosphides, facilitating a deeper potassiation of the BP anode. As a result, the modified BP anode exhibits a high reversible capacity and extended operational lifespan, coupled with a high areal capacity. This work introduces a new perspective on overcoming the trade-off between low-strain and deep-potassiation in alloy anodes for the development of high-energy and stable potassium-ion batteries.

Association of radioactive iodine treatment in differentiated thyroid cancer and cardiovascular death: a large population-based study

PURPOSE

The risk of cardiovascular diseases' death (CVD) in patients with differentiated thyroid cancer (DTC) treated with radioactive iodine (RAI) after surgery has not been adequately studied.

METHODS

Data of DTC patients who received RAI after surgery were retrieved from the Surveillance, Epidemiology, and End Result (SEER) database (2004-2015). Standardized mortality rate (SMR) analysis was used to evaluate the CVD risk in patients with RAI vs general population. A 1:1 propensity score matching (PSM) was applied to balance inter-group bias, and Pearson's correlation coefficient was used to detect collinearity between variables. The Cox proportional hazard model and multivariate competing risk model were utilized to evaluate the impact of RAI on CVD. At last, we curved forest plots to compare differences in factors significantly associated with CVD or cancer-related deaths.

RESULTS

DTC patients with RAI treatment showed lower SMR for CVD than general population (RAI: SMR = 0.66, 95% CI 0.62-0.71, P < 0.05). After PSM, Cox proportional hazard regression demonstrated a decreased risk of CVD among patients with RAI compared to patients without (HR = 0.76, 95% CI 0.6-0.97, P = 0.029). However, in competing risk regression analysis, there was no significant difference (adjusted HR = 0.82, 95% CI 0.66-1.01, P = 0.11). The independent risk factors associated with CVD were different from those associated with cancer-related deaths.

CONCLUSION

The CVD risk between DTC patients treated with RAI and those who did not was no statistical difference. Noteworthy, they had decreased CVD risk compared with the general population.

Bifunctional Interphase Promotes Li+ De-Solvation and Transportation Enabling Fast-Charging Graphite Anode at Low Temperature

The most successful lithium-ion batteries (LIBs) based on ethylene carbonate electrolytes and graphite anodes still suffer from severe energy and power loss at temperatures below -20 °C, which is because of high viscosity or even solidification of electrolytes, sluggish de-solvation of Li+ at the electrode surface, and slow Li+ transportation in solid electrolyte interphase (SEI). Here, a coherent lithium phosphide (Li3 P) coating firmly bonding to the graphite surface to effectively address these challenges is engineered. The dense, continuous, and robust Li3 P interphase with high ionic conductivity enhances Li+ transportation across the SEI. Plus, it promotes Li+ de-solvation through an electron transfer mechanism, which simultaneously accelerates the charge transport kinetics and stands against the co-intercalation of low-melting-point solvent molecules, such as propylene carbonate (PC), 1,3-dioxolane, and 1,2-dimethoxyethane. Consequently, an unprecedented combination of high-capacity retention and fast-charging ability for LIBs at low temperatures is achieved. In full-cells encompassing the Li3 P-coated graphite anode and PC electrolytes, an impressive 70% of their room-temperature capacity is attained at -20 °C with a 4 C charging rate and a 65% capacity retention is achieved at -40 °C with a 0.05 C charging rate. This research pioneers a transformative trajectory in fortifying LIB performance in cryogenic environments.

[Clinical and imaging features of acute encephalopathy with biphasic seizures and late reduced diffusion in children]

Objective: To explore the clinical and imaging features of acute encephalopathy with biphasic seizures and late reduced diffusion(AESD) in children. Methods: For the case series study, 21 children with AESD from Peking University First Hospital, Provincial Children's Hospital Affiliated to Anhui Medical University, Children's Hospital of Fudan University, and Shanxi Children's Hospital who were diagnosed and treated from October 2021 to July 2023 were selected. Clinical data were collected to summarize their clinical information, imaging, and laboratory tests, as well as treatment and prognostic characteristics. Descriptive statistical analysis was applicated. Results: Of the 21 cases with AESD, 11 were males and 10 were females, with the age of onset of 2 years and 6 months (1 year and 7 months, 3 years and 6 months). Of the 21 cases, 18 were typical cases with biphasic seizures. All typical cases had early seizures within 24 hours before or after fever onset. Among them, 16 cases had generalized seizures, 2 cases had focal seizures, and 7 cases reached the status epilepticus. Of the 21 cases, 3 atypical cases had late seizures in biphasic only. The late seizures in the 21 cases occurred on days 3 to 9. The types of late seizures included focal seizures in 12 cases, generalized seizures in 6 cases, and both focal and generalized seizures in 3 cases. Diffusion-weighted imaging (DWI) test on days 3 to 11 showed reduced diffusion of subcortical white matter which was named "bright tree sign" in all cases. The diffuse cerebral atrophy predominantly presented in the front-parietal-temporal lobes was found in 19 cases between day 12 and 3 months after the onset of the disease. Among 21 cases, 20 had been misdiagnosed as autoimmune encephalitis, central nervous system infection, febrile convulsions, posterior reversible encephalopathy syndrome, acute disseminated encephalomyelitis, and hemiconvulsion-hemiplegia-epilepsy syndrome. All the cases received high-dose gammaglobulin and methylprednisolone pulse therapy with poor therapeutic effect. By July 2023, 18 cases were under follow-up. Among them, 17 cases were left with varying degrees of neurologic sequelae, including 11 cases with post-encephalopathic epilepsy; 1 recovered completely. Conclusions: AESD is characterized by biphasic seizures clinically and "bright tree sign" on DWI images. Symptomatic and supportive treatments are recommended. The immunotherapy is ineffective. The prognosis of AESD is poor, with a high incidence of neurological sequelae and a low mortality.

Does Dual Anti-HER2 Therapy Increase Early Cardiac Toxicity in Comparison with Trastuzumab Alone in Breast Cancer Patients Receiving Adjuvant Radiotherapy? A Multicenter Retrospective Study

PURPOSE/OBJECTIVE(S)

Adjuvant trastuzumab in combination with RT has proved its safety in terms of cardiac events. Dual anti-HER2 therapy with pertuzumab is currently standard adjuvant therapy in N+ and high-risk N0 early breast cancer (BC) patients. Our study aims to find if it increases early cardiac toxicity compared with trastuzumab alone in BC patients receiving adjuvant radiotherapy.

MATERIALS/METHODS

Operable BC patients who received adjuvant radiotherapy (RT) and trastuzumab with or without pertuzumab between January 2017 and September 2020 in 7 Chinese centers were retrospectively reviewed. The cardiac examination included ultrasonography, electrocardiogram (ECG), NT-proBNP, and cTnI before RT and during follow-up. The cardiac event was any new-onset symptomatic heart disease or abnormality in the cardiac examination after RT.

RESULTS

In total, 711 patients with a median age of 52 years were included, of whom 567 (79.7%) patients were treated with trastuzumab-only and 144 (20.3%) patients received dual anti-HER2 therapy. Adjuvant RT was given concurrently in 140/144 (97.2%) of dual anti-HER2 therapy and 562/567 (99.1%) of trastuzumab alone, respectively. With a median follow-up of 11 months, no patients developed symptomatic heart diseases. Among patients with normal baseline, 17 (2.4%), 86 (12.1%), 18 (2.5%) and 14 (7.3%) developed new-onset diastolic dysfunction, left ventricular ejection fraction (LVEF) decline, abnormal ECG, and abnormal NT-proBNP, respectively. No significant difference was found between the trastuzumab-only and dual anti-HER2 cohort in the incidence of all kinds of new-onset cardiac events (all p > 0.1). Multivariate analysis showed that left-sided (vs right-sided) RT significantly increased the risk of ECG abnormality (HR = 2.32, 95% CI 1.62-3.32, p<0.001). Increased age was an independent risk factor for diastolic dysfunction (HR = 1.1, 95% CI 1.02-1.18, p = 0.0098). Dosimetric analysis showed that patients who developed any cardiac events had increased mean heart dose (397.67±251.08 vs 344.87±236.75 cGy, p = 0.032). A significant increase in risk of cardiac events was found in patients with mean heart dose > 450 cGy (HR = 1.55, 95% CI 1.17-2.05, p = 0.0024), V5 > 26% (HR = 1.51, 95% CI 1.09-2.09, p = 0.013), and V30 > 5.5% (HR = 1.49, 95% CI 1.09-2.04, p = 0.0117), respectively. Further analysis was done in the subgroup of patients treated with left-sided RT, internal mammary nodes RT, or anthracyclines, no difference in risk of cardiac events was found between trastuzumab alone and dual anti-HER2 therapy in concurrent with RT (all p > 0.05).

CONCLUSION

Compared with trastuzumab-only, dual anti-HER2 therapy does not increase early cardiac toxicity in combination with adjuvant RT in BC patients. Cardiac radiation exposure remains the primary risk factor associated with early cardiac toxicity.

Delta-Radiomics Guides Adaptive De-Intensification after Induction Chemotherapy in Locoregionally Advanced Nasopharyngeal Carcinoma in the IMRT Era

PURPOSE/OBJECTIVE(S)

In the setting of intensity-modulated radiotherapy (IMRT) and induction chemotherapy (IC), the benefits from concurrent chemotherapy remained controversial for locoregionally advanced nasopharyngeal carcinoma (LANPC). This study aimed to construct a delta-radiomics model for benefit prediction and patient selection for omitting concurrent chemotherapy.

MATERIALS/METHODS

Between December 2009 and December 2015, a total of 718 patients with LANPC treated with IC+IMRT or IC+concurrent chemoradiotherapy (CCRT) were retrospectively enrolled and randomly assigned to a training set (n = 503) and a validation set (n = 215). Radiomic features were extracted from magnetic resonance images of pre-IC and post-IC. Interclass correlation coefficients and Pearson correlation coefficients were calculated to select robust radiomic features. After univariate Cox analysis, a delta-radiomics signature was built using the LASSO-Cox regression. A nomogram incorporating the delta-radiomics signature and clinical prognostic factors was then developed and evaluated for calibration and discrimination. Risk stratification by the nomogram was evaluated by Kaplan-Meier methods. The primary outcome was overall survival (OS).

RESULTS

The delta-radiomics signature, which comprised 19 selected features, was independently associated with prognosis. It yielded an area under the receiver operating characteristic curve (AUC) of 0.77 (95% confidence interval [CI] 0.71 to 0.82) for the training set and 0.71 (95% CI 0.61 to 0.81) for the validation set. The nomogram composed of the delta-radiomic signature, age, T category, N category, pre-treatment Epstein-Barr virus DNA, and treatment showed great calibration and discrimination performance with an AUC of 0.80 (95% CI 0.75 to 0.85) for the training set and 0.75 (95% CI 0.64 to 0.85) for the validation set. Risk stratification by the nomogram excluding the treatment variable resulted in two risk groups with distinct OS. Significant better outcomes were observed in the high-risk patients with IC+CCRT compared to those with IC+IMRT (5-year OS: 73.8% vs. 61.4% in the training set and 85.8% vs. 65.6% in the validation set; all log-rank p < 0.05), while comparable outcomes between IC+CCRT and IC+IMRT were shown for the low-risk patients (95.8% vs. 95.8% in the training set and 92.2% vs. 88.3% in the validation set; all log-rank p > 0.05).

CONCLUSION

The delta-radiomics signature was identified as an independent indicator of LANPC. Integrating clinical predictors with the delta-radiomics signature, the radiomics-based nomogram could predict individual's survival outcomes and benefits from concurrent chemotherapy after IC for LANPC. Low-risk patients with LANPC determined by the nomogram may be potential candidates for omission of concurrent chemotherapy following IC in the IMRT era.

[Value of autocrine motility factors in the prediction of the disease progression of PBC- associated hepatocellular carcinoma]

Objective: To clarify the value of autocrine motility factor (ATX) in predicting the disease progression of primary biliary cholangitis (PBC)-associated hepatocellular carcinoma (HCC). Methods: A prospective cohort of 179 newly diagnosed autoimmune liver disease (PBC) patients admitted to the Department of Hepatology at the Fifth Medical Center of the People's Liberation Army General Hospital from January 2016 to January 2018 was selected. All PBC patients received ursodeoxycholic acid (UDCA) treatment and were followed up.The endpoint of the follow-up was the occurrence of primary liver cancer. The relationship between ATX and the clinical characteristics of patients and its significance in predicting disease progression and HCC were analyzed. Results: The peripheral blood ATX level was significantly higher in PBC patients than that of alcoholic cirrhosis (t = 3.278, P = 0.001) and healthy controls (t = 6.594, P < 0.001), but there was no significant difference in ATX levels compared with patients with non-PBC- associated HCC (t = -0.240, P = 0.811). The expression of ATX in liver tissue of PBC patients was significantly higher than that of healthy individuals (Z = -3.633, P < 0.001) and patients with alcoholic cirrhosis (Z = -3.283, P < 0.001), while the expression of ATX in the advanced stage was significantly higher than that in early-stage PBC patients (Z = -2.018, P = 0.034). There was a significant difference in baseline ATX levels between PBC patients without HCC and PBC patients with HCC (228.451 ± 124.093 ng/ml vs. 301.583 ± 100.512 ng/ml, t = 2.339, P = 0.021). Multivariate logistic regression analysis showed that ATX was an independent predictor of PBC progression to HCC (OR = 1.245, 95%CI 1.097-1.413). The baseline peripheral blood ATX level in predicting AUROC of PBC-associated HCC was 0.714, 95%CI 0.597-0.857 and the sensitivity and specificity were 84.6%, and 59.0%, respectively. The optimal cutoff value for predicting serum ATX levels in the occurrence of HCC was 235.254 ng/ml. Conclusion: Patients with PBC have significantly higher levels of ATX expression in their peripheral blood and liver tissue, which can be utilized to assess treatment effectiveness and predict disease progression.

Local Sn Dipolar-Character Displacements behind the Low Thermal Conductivity in SnSe Thermoelectric

The local atomic structure of SnSe was characterized across its orthorhombic-to-orthorhombic structural phase transition using x-ray pair distribution function analysis. Substantial Sn displacements with a dipolar character persist in the high-symmetry high-temperature phase, albeit with a symmetry different from that of the ordered displacements below the transition. The analysis implies that the transition is neither order-disorder nor displacive but rather a complex crossover. Robust ferrocoupled SnSe intralayer distortions suggest a ferroelectriclike instability as the driving force. These local symmetry-lowering Sn displacements are likely integral to the ultralow lattice thermal conductivity mechanism in SnSe.

Characterization of pyroptosis-related genes in esophageal cancer and construction of a prognostic model

OBJECTIVE

Esophageal cancer (EC) is a highly malignant digestive system tumor that often lacks evident early symptoms and has a poor prognosis. Pyroptosis, a form of programmed cell death, has been shown to be associated with the occurrence and progression of many malignancies. However, its role in esophageal cancer remains unclear. This work aimed to evaluate the prognostic value of pyroptosis-related genes (PRGs) in EC using data from The Cancer Genome Atlas (TCGA) cohort.

MATERIALS AND METHODS

The RNA-seq data from 171 esophageal samples in the TCGA database were employed. Differential expression genes (DEGs) between tumor and non-tumor samples were compared. Protein-protein interaction (PPI) networks were constructed using the STRING database, and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment and Gene Ontology (GO) analyses were performed using the "clusterProfiler" package in R. Furthermore, based on the DEGs, all esophageal cancer cases were classified into three subtypes. A risk model for gene features was established using the LASSO regression method, and EC patients in the TCGA cohort were divided into high-risk and low-risk groups.

RESULTS

A total of 614 PRGs were identified. Among them, 32 DEGs (31 upregulated and 1 downregulated) were found between normal esophageal tissue and EC tissue. PPI analysis identified key genes including IL-1β, CASP1, AIM2, HMGB1, GSDMD, PYCARD, IL-18, BAK1, and TP53. On the other hand, the low-risk group exhibited a significantly higher survival rate than the high-risk group (p < 0.001). Combined with the clinical characteristics of the TCGA cohort, it was found that the risk score was an independent prognostic factor for overall survival (OS) prediction in EC patients. KEGG and GO analyses revealed the enrichment of genes associated with cell proliferation in the high-risk group.

CONCLUSIONS

PRGs play a crucial role in the occurrence and development of EC and can be used to predict the prognosis of EC patients.

A Superior Two-Dimensional Phosphorus Flame Retardant: Few-Layer Black Phosphorus

The usage of flame retardants in flammable polymers has been an effective way to protect both lives and material goods from accidental fires. Phosphorus flame retardants have the potential to be follow-on flame retardants after halogenated variants, because of their low toxicity, high efficiency and compatibility. Recently, the emerging allotrope of phosphorus, two-dimensional black phosphorus, as a flame retardant has been developed. To further understand its performance in flame-retardant efficiency among phosphorus flame retardants, in this work, we built model materials to compare the flame-retardant performances of few-layer black phosphorus, red phosphorus nanoparticles, and triphenyl phosphate as flame-retardant additives in cellulose and polyacrylonitrile. Aside from the superior flame retardancy in polyacrylonitrile, few-layer black phosphorus in cellulose showed the superior flame-retardant efficiency in self-extinguishing, ~1.8 and ~4.4 times that of red phosphorus nanoparticles and triphenyl phosphate with similar lateral size and mass load (2.5~4.8 wt%), respectively. The char layer in cellulose coated with the few-layer black phosphorus after combustion was more continuous and smoother than that with red phosphorus nanoparticles, triphenyl phosphate and blank, and the amount of residues of cellulose coated with the few-layer black phosphorus in thermogravimetric analysis were 10 wt%, 14 wt% and 14 wt% more than that with red phosphorus nanoparticles, triphenyl phosphate and blank, respectively. In addition, although exothermic reactions, the combustion enthalpy changes in the few-layer black phosphorus (-127.1 kJ mol^-1) are one third of that of red phosphorus nanoparticles (-381.3 kJ mol^-1). Based on a joint thermodynamic, spectroscopic, and microscopic analysis, the superior flame retardancy of the few-layer black phosphorus was attributed to superior combustion reaction suppression from the two-dimensional structure and thermal nature of the few-layer black phosphorus.

[Prevalence of Angiostrongylus cantonensis infection in snails in Fujian Province from 2017 to 2021]

OBJECTIVE

To investigate the prevalence of Angiostrongylus cantonensis infection in market-sold and field-captured snails in Fujian Province, so as to provide the scientific basis for the formulation of the angiostrongyliasis control measures.

METHODS

In each month from May to October during the period from 2017 through 2021, Pomacea snails were collected from two field fixed surveillance sites and Bellamya aeruginosa collected from one agricultural product market in Fuzhou City, while Pomacea and B. aeruginosa snails were collected from two agricultural product markets and four restaurants in Xiamen City. At least 50 Pomacea snails and 500 g B. aeruginosa were sampled each time. A. cantonensis infection was detected in Pomacea snails using lung microscopy, and in B. aeruginosa using a tissue homogenate method.

RESULTS

A total of 9 531 Pomacea snails were detected for A. cantonensis infection in two cities of Fuzhou and Xiamen, and the overall prevalence of A. cantonensis infection was 4.40%, with the highest prevalence in 2017 (6.82%, 116/1 701) and the lowest prevalence in 2019 (3.46%, 83/2 400). The prevalence of A. cantonensis infection was significantly higher in Pomacea snails sampled from Fuzhou City (11.23%, 326/2 903) than from Xiamen City (1.40%, 93/6 628) (χ² = 461.48, P < 0.01). A. cantonensis larvae were detected in larval Pomacea snails in two cities of Fuzhou and Xiamen each month. The prevalence of A. cantonensis infection in Pomacea snails appeared an overall tendency towards a rise with month in Fuzhou City, with the highest prevalence in October (15.24%), and there was a significant difference among month (χ² = 14.56, P < 0.05), while the prevalence of A. cantonensis infection in Pomacea snails was low in Pomacea snails sampled from Xiamen City each month, with the highest prevalence in June (2.64%), and there was a significant difference among month (χ² = 23.17, P < 0.05). A total of 18 966 B. aeruginosa snails were detected for A. cantonensis infection in two cities of Fuzhou and Xiamen, and the overall prevalence of A. cantonensis infection was 0.01%.

CONCLUSIONS

A. cantonensis infection was identified in Pomacea and B. aeruginosa snails in Fujian Province from 2017 to 2021, and there is a potential risk of human A. cantonensis infection.

[Identification of potential influencing factors associated with elimination of migraine headache in patients with PFO after percutaneous closure]

Objective: To recognize the potential factors that contribute to the eradication of migraine headache in patients with patent foramen ovale (PFO) at one year after percutaneous closure. Methods: A prospective cohort study was conducted, which enrolled patients diagnosed with migraines and PFO at the Department of Structural Heart Disease, First Affiliated Hospital of Xi'an Jiaotong University between May 2016 and May 2018. The patients were segregated into two groups based on their response to treatment, and one group showed elimination of migraines while another did not. Elimination of migraines was defined as a Migraine Disability Assessment Score (MIDAS) score of 0 at one year postoperatively. Least Absolute Shrinkage and Selection Operator (LASSO) regression model was utilized to identify the predictive variables for migraine elimination post-PFO closure. Multiple logistic regression analysis was employed to determine the independent predictive factors. Results: The study enrolled a total of 247 patients, with an average age of (37.5±13.6) years, comprising 81 male individuals (32.8%). One year after closure, 148 patients (59.9%) reported eradication of their migraines. Multivariate logistic regression analysis revealed that migraine with or without aura (OR=0.003 9, 95%CI 0.000 2-0.058 7, P=0.000 18), a history of antiplatelet medication use (OR=0.088 2, 95%CI 0.013 7-0.319 3, P=0.001 48) and resting right-to-left shunt (RLS) (OR=6.883 6, 95%CI 3.769 2-13.548 0, P<0.001) were identified as independent predictive factors for elimination of migraine. Conclusion: Migraine with or without aura, a history of antiplatelet medication use, and resting RLS are the independent prognostic factors associated with elimination of migraine. These results provide important clues for clinicians to choose the optimal treatment plan for PFO patients. However, further studies are needed to confirm these findings.

Construction of a prognostic signature of RFC5 immune-related genes in patients with cervical cancer

BACKGROUND

Cervical cancer (CC) is a malignant tumor threatening women's health. Replication factor C (RFC) 5 is significantly highly expressed in CC tissues, and the immune microenvironment plays a crucial role in tumor initiation, progression, and metastasis.

OBJECTIVE

To determine the prognostic role of RFC5 in CC, analyze the immune genes significantly associated with RFC5, and establish a nomogram to evaluate the prognosis of patients with CC.

METHODS

High RFC5 expression in patients with CC was analyzed and verified through TCGA GEO, TIMER2.0, and HPA databases. A risk score model was constructed using RFC5-related immune genes identified using R packages. Combining the risk score model and clinical information of patients with CC, a nomogram was constructed to evaluate the prognosis of patients with CC.

RESULTS

Comprehensive analysis showed that the risk score was a prognostic factor for CC. The nomogram could predict the 3-year overall survival of patients with CC.

CONCLUSIONS

RFC5 was validated as a biomarker for CC. The RFC5 related immune genes were used to establish a new prognostic model of CC.

Adsorption-Assisted Redox Center in Porous Organic Frameworks for Boosting Lithium Storage

Due to the designable structure and capacity, organic materials are promising candidates for lithium-ion batteries. Herein, we report a novel type of porous organic frameworks (POFs) based on the coupling reaction of diazonium salt as the anodes for lithium ion storage. The active center containing an azo group and the adjacent lithium-philic adsorption site is constructed to investigate the electrochemical behaviors and reaction mechanism. As synthesized POF material (named as POF-AN) exhibits high reversible lithium storage capacities of 523 mAh g^-1 at 0.5 A g^-1 and 445 mAh g^-1 at 2.0 A g^-1 after 1500 cycles, showing excellent cycle stability and rate performance. The detailed characterizations reveal that the azo group can act as an electrochemical active site that reversibly bonds with Li-ions, and the adjacent oxygen atoms can electrostatically adsorb with Li-ions to promote the lithium storage reaction. This adsorption-assisted three-atom redox center is beneficial to synergistically enhance the adsorption and intercalation of lithium ions, which can further improve the capacity and cycle stability. By replacing the precursor, it is also facile to synthesize more similar structure types. The reversible redox chemistry of the adsorption-assisted three-atom active center provides new opportunities for the development of long lifespan and high-rate organic anodes.

Comparative Study of Graft Healing in 2 Years after “Tension Suspension” Remnant-Preserving and Non-Remnant-Preserving Anatomical Reconstruction for Sherman Type II Anterior Cruciate Ligament Injury

Purpose: To evaluate the degree of graft healing after “tension suspension” reconstruction of “Sherman II” anterior cruciate ligament injuries versus non-remnant preserving anatomical reconstruction and to compare the clinical outcomes of the two procedures. Method: The clinical data of 64 patients were retrospectively included. There were 31 cases in the “tension suspension” remnant-preserving reconstruction group and 33 cases in the non-remnant-preserving anatomical reconstruction group. The International Knee Documentation Committee (IKDC) score, the Tegner score, and the Lysholm activity score were assessed preoperatively and at 6 months, 1 year, and 2 years postoperatively, respectively. The signal/noise quotient (SNQ) of the grafts was measured at 6 months, 1 year, and 2 years after surgery to quantitatively evaluate the maturity of the grafts after ACL reconstruction; the fractional anisotropy (FA) and apparent diffusion coefficient (ADC) of the reconstructed ACL region of interest (ROI) were measured using DTI. Result: A total of 64 patients were included in the study. The mean SNQ values of the grafts in the 6 months, 1 year, and 2 years postoperative remnant-preserving reconstruction (RP) groups were lower than those in the non-remnant-preserving (NRP) reconstruction group, with a statistically significant difference (p < 0.05). At each postoperative follow-up, the SNQ values of the tibial and femoral sides of the RP group were lower than those of the NRP group; the SNQ values of the femoral side of the grafts in both groups were higher than those of the tibial side, and the differences were statistically significant (p < 0.05). At 6 months, 1 year, and 2 years postoperatively, the FA and ADC values of the grafts were lower in the RP group than in the NRP group, and the differences were statistically significant (p < 0.05); the IKDC score and Lysholm score of the RP group were higher than the NRP group, which was statistically significant (p < 0.05). Conclusion: For Sherman II ACL injury, the graft healing including ligamentization and revascularization at 2 years after the “tension suspension” remnant-preserving reconstruction was better than that of non-remnant-preserving anatomic reconstruction.

[Prevalence of Anisakise infections in marine fishes in Eastern Fujian Fishing Ground of Fujian Province]

OBJECTIVE

To investigate the prevalence of Anisakis infection in marine fishes in Eastern Fujian Fishing Ground of Fujian Province, so as to provide insights into the development of the anisakiasis control strategy.

METHODS

Marine fish samples were randomly collected from Jiaocheng District, Fuding City and Xiapu County around Eastern Fujian Fishing Ground in Fujian Province from September to December, 2021. All fishes were dissected, and the abdominal contents were collected. Parasites were sampled under a stereomicroscope and the Anisakis species were identified through morphology. The prevalence and intensity of Anisakis infections were calculated.

RESULTS

A total of 177 marine fishes belonging to 24 species were dissected, and Anisakis was detected in 73 marine fishes (41.2%) belonging to 16 species (66.7%), with a mean infection intensity of 14.3 parasites per fish. High prevalence of Anisakis infection was found in Ilisha elongata (5/5), Miichthys miiuy (3/3), Plectorhynchus cinctus (2/2), Scomberomorus niphonius (12/13), Trichiurus lepturus (19/23), Pennahia argentata (6/11) and Ditrema temmincki (14/27), with mean infection intensities of 9.2, 2.7, 4.5, 10.9, 39.2, 4.5 parasites per fish and 2.1 parasites per fish. The Anisakis larvae were characterized as Anisakis and Hysterothylacium.

CONCLUSIONS

High prevalence of Anisakis infection is detected in marine fishes in Eastern Fujian Fishing Ground of Fujian Province. The health education pertaining to food health is required to be reinforced to prevent the development of human anisakiasis.

Effects of remnant preservation in anterior cruciate ligament reconstruction: A systematic review and meta-analysis

Background

Compared with standard anterior cruciate ligament (ACL) reconstruction, it is controversial whether anterior cruciate ligament reconstruction (ACLR) with remnant preservation can lead to better clinical outcomes. We conducted a systematic study and meta-analysis to assess the differences in clinical efficacy between the two.

Method

We searched for clinical randomized controlled studies and cohort studies included in the Cochrane library, PubMed, and Embase from March 2012 to March 2022 in English. The included studies were ACLR with or without remant preservation, and the data were extracted and the quality of the included studies was assessed by two authors, respectively. Revman 5.4 was used for statistical analysis and conclusions were presented.

Result

Ten articles containing a total of 777 patients were finally included. There was no significant difference in postoperative Lachman test [OR = 1.66, 95%CI (0.79, 3.49), P = 0.18 > 0.05], Tegner score [SMD = −0.13, 95%CI (−0.47, 0.22), P = 0.46 > 0.05], synovial coverage rate by second-look arthroscopy [OR = 1.55, 95%CI (0.66, 3.65), P = 0.32 > 0.05], the rate of cyclops lesion [OR = 3.92, 95%CI (0.53, 29.29), P = 0.18 > 0.05], joint range of motion [SMD = 0.27, 95%CI (−0.13, 0.68), P = 0.19 > 0.05] and re-injury rate [OR = 0.57, 95%CI (0.18, 1.74), P = 0.32 > 0.05] between the two groups. There were statistically significant differences in postoperative Lysholm score [SMD = 0.98, 95% CI (0.32, 1.64), P = 0.004 < 0.05], International Knee Documantation Committee grade (IKDC grade) [OR = 2.19, 95%CI (1.03, 4.65), P = 0.04 < 0.05], Pivot shift test [OR = 1.71, 95%CI (1.06, 2.77), P = 0.03 < 0.05], KT1000/2000 arthrometer side-to-side difference [SMD = −0.22, 95%CI (−0.42, −0.03), P = 0.02 < 0.05], operation time [SMD = 11.69, 95%CI (8.85, 14.54), P = 0.00001 < 0.05] and degree of tibial tunnel enlargement [SMD = −0.66, 95%CI (−1.08, −0.23), P = 0.002 < 0.05].

Conclusion

This meta-analysis concluded that remnant preservation significantly had better results in terms of patient functional score (Lysholm, IKDC), knee stability (Pivot shift test, postoperative side-to-side anterior laxity) and tibial tunnel enlargement. In terms of complications (incidence of Cyclops lesions, range of motion, re-injury rate), no significant differences were seen between the two groups. Although many studies concluded that remnant preservation could bring better synovial coverage, this meta-analysis indicated that there is insufficient evidence to support it, possibly due to different remnant preservation procedures.The potential risks associated with longer operation times are also worth considering.

OP0093 INCREASED RISK OF SEVERE INFECTIONS AND MORTALITY IN PATIENTS WITH NEWLY DIAGNOSED ANTINEUTROPHIL CYTOPLASMIC ANTIBODY ASSOCIATED VASCULITIS: A POPULATION-BASED STUDY

Background

Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitides (AAVs) are a group of multisystem inflammatory diseases of the small blood vessels, characterized by leukocytoclastic inflammation of small blood vessels and triggered by production of ANCA autoantibodies [1]. Due to the multiorgan involvement and relapsing nature, AAV is among the systemic autoimmune rheumatic diseases with the highest morbidity and mortality [1, 2].

Objectives

To evaluate the risk of severe infection and infection-related mortality among patients with newly diagnosed AAV.

Methods

We conducted an age- and gender- matched cohort study of all patients with incident AAV between January 1, 1997 and March 31, 2015 using administrative health data from British Columbia, Canada. Primary outcome was the first severe infection after AAV onset necessitating hospitalization or occurring during hospitalization. Secondary outcomes were total number of severe infections and infection-related mortality.

Results

We identified 549 AAV patients and matched them with 5,490 non-AAV individuals from the general population, yielding 184 and 509 first severe infections during 2,539 and 33,342 person-years follow-up, respectively. The crude incidence rate ratios for first severe infection and infection-related mortality were 5.03 (95% CI, 4.25-5.96) and 3.72 (95% CI, 2.44-5.67), respectively. The corresponding adjusted hazard ratios were 3.77 (95% CI 2.94-4.85) and 3.84 (95% CI, 2.13-6.91). AAV patients had an increased risk of a greater total number of severe infections with crude rate ratio of 4.99 (95% CI, 4.42-5.62) and adjusted rate ratio of 3.20 (95% CI, 2.73-3.74).

Conclusion

AAV is independently associated with increased risks of first severe infection (3.8-fold), a greater total number of severe infections (3.2-fold) and infection-related mortality (3.8-fold).

References

[1]Jennette JC, Falk RJ, Bacon PA, et al. 2012 revised International Chapel Hill Consensus Conference Nomenclature of Vasculitides. Arthritis Rheum 2013;65(1):1-11.

[2]Little MA, Nightingale P, Verburgh CA, et al. Early mortality in systemic vasculitis: relative contribution of adverse events and active vasculitis. Ann Rheum Dis 2010;69(6):1036-43.

Table 1.

Risk of severe infection in AAV relative to non-AAV during follow-up

Post-AAV diagnosis first severe infectionAAV cohortNon-AAV cohortN=549N=5,490No. of events184509IR per 1,000 person-years72.4614.40IRR (95% CI)5.03 (4.25-5.96)1Age and gender adjusted HR (95% CI)5.29 (4.43-6.31)1All but GC adjusted HR (95% CI)3.32 (2.67-4.13)1Fully adjusted HR* (95% CI)3.77 (2.94-4.85)1Post-AAV total number of severe infectionsInfection episodes396868IR per 1,000 person-years116.4223.35IRR (95% CI)4.99 (4.42-5.62)1Age and gender adjusted rate ratio (95% CI)5.27 (4.78-5.93)1All but GC adjusted rate ratio (95% CI)3.13 (2.72-3.59)1Fully adjusted rate ratio* (95% CI)3.20 (2.73-3.74)1Infection-related mortalityNo. of infection-related death events2985IR per 1,000 person-years8.532.29IRR (95% CI)3.72 (2.44-5.67)1Age and gender adjusted HR (95% CI)4.43 (2.89-6.79)1All but GC adjusted HR (95% CI)3.67 (2.14-6.31)1Fully adjusted HR* (95% CI)3.84 (2.13-6.91)1

Abbreviations: AAV, Antineutrophil cytoplasmic antibody-associated vasculitides; IR, incidence rate; IRR, incidence rate ratio; HR, hazard ratio; CI, confidence interval.

*Adjusted for baseline covariates. All but GC HRs represent the total effect while fully adjusted HRs represent the direct effect of AAV.

Disclosure of Interests

None declared.

POS0521 RISKS OF SEVERE INFECTION AFTER THE INTRODUCTION OF bDMARDs IN NEWLY DIAGNOSED RHEUMATOID ARTHRITIS PATIENTS: A POPULATION-BASED INTERRUPTED TIME-SERIES ANALYSIS

Background

Biological disease-modifying anti-rheumatic drugs (bDMARDs) are effective in suppressing inflammation and preventing joint damage. But bDMARDs may be associated with increased risk of severe infection. Evidence on this is contradictory with some studies showing increased risk, whereas others reporting no significant changes.

Objectives

To determine the impact of the introduction of bDMARDs on severe infection among patients newly diagnosed with RA compared with non-RA individuals.

Methods

In this age- and gender-matched cohort study using administrative health data for the population of BC, Canada, all incident RA patients diagnosed between 1995–2007 were identified. Non-RA individuals were randomly selected from the general control population to match with RA. Incident RA/non-RA individuals were then divided into quarterly cohorts according to their diagnosis date. Two outcomes were examined: (1) first severe infection (FSI) after RA onset necessitating hospitalization or occurring during hospitalization; and (2) all severe infections (ASI) after RA onset. We calculated the 8-year FSI and ASI rate for each cohort. We conducted interrupted time-series analyses to compare levels and trends of FSI and ASI in RA and non-RA individuals diagnosed during pre-bDMARDs (1995–2001) and post-bDMARDs (2003–2007) periods. Adjusted 8-year FSI and ASI rates for RA and non-RA cohorts diagnosed five years after bDMARDs introduction were compared with expected rates assuming no bDMARDs introduction, based on extrapolation of pre-bDMARDs trends.

Results

A total of 60,226 and 588,499 incident RA/non-RA individuals were identified. We identified 8,954 FSI and 14,245 ASI in RA, and 56,153 FSI and 79,819 ASI in non-RA. The 8-year FSI rates among RA patients diagnosed in the pre-bDMARDs period decreased over time but leveled off among those diagnosed in the post-period (Figure 1). The adjusted difference between the post- and pre-bDMARDs secular trends of 8-year FSI rates was 0.68 (p=0.03) in RA and 0.03 (p=0.67) in non-RA (Table 1). The 8-year ASI rates among RA patients diagnosed in the pre-bDMARDs period decreased over time but increased significantly among those diagnosed in the post-period (Figure 1). The adjusted difference between the post- and pre-bDMARDs secular trends of 8-year ASI rates was 1.85 (p=0.001) in RA and 0.12 (p=0.29) in non-RA (Table 1). For RA cohort diagnosed 5 years after bDMARDs introduction, ASI rate increased by 20.4% than expected rates assuming no bDMARDs introduction. In contrast, ASI rate in non-RA increased by only 10.9%.

Table 1.

Results of interrupted time-series analysis of FSI/ASI rates, adjusting for age, gender, chronic obstructive pulmonary disease, Romano Charlson Comorbidity Index, diabetes, chronic kidney diseases, alcoholism, cancer, prior hospitalization with infection and socio-economic status at disease diagnosis year, using stepwise model selection

OutcomeParameterRANon-RAUnadj. Diff (95% CI)Adj. Diff (95% CI)Unadj. Diff (95% CI)Adj. Diff (95% CI)p-valuep-valuep-valuep-valueFSITrend0.63 (0.03, 1.22) 0.04410.68 (0.09, 1.27) 0.02920.08 (-0.08, 0.25) 0.32370.03 (-0.12, 0.19) 0.6728Level (1 year post-intervention)0.50 (-2.00, 2.99) 0.69890.31 (-1.88, 2.49) 0.78470.41 (-0.21, 1.03) 0.20410.26 (-0.24, 0.75) 0.31035 years post-intervention3.01 (-0.85, 6.87) 0.13313.02 (-0.48, 6.52) 0.09860.75 (-0.24, 1.73) 0.14330.39 (-0.46, 1.25) 0.3721ASITrend1.84 (0.83, 2.84) 0.00091.85 (0.81, 2.89) 0.00110.28 (0.04, 0.53) 0.03050.12 (-0.10, 0.34) 0.2877Level (1 year post-intervention)-1.21 (-5.41, 3.00) 0.5763-1.44 (-5.44, 2.56) 0.48501.46 (0.42, 2.49) 0.00851.20 (0.38, 2.02) 0.00645 years post-intervention6.14 (0.26, 12.01) 0.04665.97 (0.02, 11.93) 0.05602.60 (1.08, 4.12) 0.00171.69 (0.45, 2.92) 0.0109Figure 1.

Unadjusted rates.

Conclusion

Arthritis onset after bDMARDs introduction is associated with an elevated risk of severe infection in RA patients, compared with matched non-RA individuals.

Acknowledgements

We would like to thank the Ministry of Health of British Columbia and Population Data BC for providing access to the administrative data. All inferences, opinions, and conclusions drawn in this publication are those of the authors, and do not reflect the opinions or policies of the Data Stewards or the [British Columbia] Ministry of Health. No personal identifying information was made available as part of this study. Procedures used were in compliance with British Columbia’s Freedom in Information and Privacy Protection Act. Ethics approval was obtained from the University of British Columbia’s Behavioral Research Ethics Board (H15-00887).

Disclosure of Interests

None declared.

POS0503 RISKS OF CARDIOVASCULAR EVENTS AFTER THE INTRODUCTION OF bDMARDs IN NEWLY DIAGNOSED RHEUMATOID ARTHRITIS PATIENTS: A POPULATION-BASED INTERRUPTED TIME-SERIES ANALYSIS

Background

Rheumatoid arthritis (RA) is associated with increased risk of cardiovascular (CV) events. Biological disease-modifying anti-rheumatic drugs (bDMARDs) are effective in suppressing inflammation and preventing joint damage and may help lower the risk of CV events. However, recent epidemiological studies have shown mixed results with some suggesting a lower risk of CV events, while others reporting no significant differences.

Objectives

To determine the impact of the introduction of bDMARDs on incident cardiovascular disease (CVD) among patients newly diagnosed with RA compared with matched non-RA individuals.

Methods

In this age- and gender-matched cohort study using administrative health data for the population of BC, Canada, all incident RA patients diagnosed between 1995–2007 were identified. Non-RA individuals were randomly selected from the general control population to match with RA. Incident RA and non-RA individuals were then divided into quarterly cohorts according to their diagnosis date. The outcome of interest was incident CVD event after RA onset, which include acute myocardial infarction, cerebrovascular accident, and venous thromboembolism. We calculated the 8-year incident CVD rate for each cohort. We conducted interrupted time-series analyses to compare levels and trends of CVD in RA and non-RA individuals diagnosed during pre-bDMARDs (1995–2001) and post-bDMARDs (2003–2007) periods with intervention time set at year of 2002. Adjusted 8-year CVD rates for RA and non-RA cohorts diagnosed five years after bDMARDs introduction were compared with expected rates assuming no bDMARDs introduction, based on extrapolation of pre-bDMARDs trends.

Results

A total of 60,226 and 588,499 incident RA and non-RA individuals were identified. We identified 6,740 and 48,653 incident CVD events in total in RA and non-RA individuals, respectively. We observe no change in the secular trends of the 8-year CVD rates in both RA and non-RA individuals diagnosed in pre- and post-bDMARDS periods (Figure 1): the adjusted difference between the post- and pre-bDMARDs secular trends of 8-year CVD rates was 0.23 (p=0.26) for RA patients and -0.07 (p=0.33) for non-RA individuals (Table 1). However, we observed a reduction in the level of CVD rates among RA patients diagnosed in the post-bDMARDs period and no change in non-RA (Figure 1): the adjusted difference in level comparing points immediately before and after the intervention, and accounting for pre-intervention trend was -1.61 (p=0.03) in RA, while it was -0.02 (p=0.93) in non-RA (Table 1).

Table 1.

Results of interrupted time-series analysis of incident CVD rates, adjusting for age, gender, chronic obstructive pulmonary disease, Romano Charlson Comorbidity Index, diabetes, angina, hypertension, chronic kidney disease, peripheral vascular disease, atrial fibrillation, glucocorticoid, non-steroidal anti-inflammatory drugs, CVD medications, fibrates, contraceptives, and aspirin use at disease diagnosis year, using stepwise model selection

OutcomeParameterRANon-RAUnadj. Diff (95% CI)Adj. Diff (95% CI)Unadj. Diff (95% CI)Adj. Diff (95% CI)p-valuep-valuep-valuep-valueCVDTrend-0.15 (-0.72, 0.42) 0.60860.23 (-0.17, 0.64) 0.2620-0.09 (-0.27, 0.08) 0.3084-0.07 (-0.20, 0.07) 0.3290Level (1 year post-intervention)-1.36 (-3.17, 0.45) 0.1474-1.61 (-2.96, -0.25) 0.02510.22 (-0.41, 0.84) 0.5011-0.02 (-0.44, 0.40) 0.93455 years post-intervention-1.96 (-4.48, 0.55) 0.1332-0.67 (-2.80, 1.46) 0.5418-0.15 (-1.06, 0.75) 0.7421-0.29 (-0.97, 0.39) 0.4102Figure 1.

Unadjusted rates.

Conclusion

Arthritis onset after bDMARDs introduction is associated with a significant reduction in the risk of incident CVD events among RA patients, but not in the matched non-RA individuals.

Acknowledgements

We would like to thank the Ministry of Health of British Columbia and Population Data BC for providing access to the administrative data. All inferences, opinions, and conclusions drawn in this publication are those of the authors, and do not reflect the opinions or policies of the Data Stewards or the [British Columbia] Ministry of Health. No personal identifying information was made available as part of this study. Procedures used were in compliance with British Columbia’s Freedom in Information and Privacy Protection Act. Ethics approval was obtained from the University of British Columbia’s Behavioral Research Ethics Board (H15-00887).

Disclosure of Interests

None declared.

OP0248 SEVERE COVID-19 OUTCOMES AMONG PATIENTS WITH AUTOIMMUNE RHEUMATIC DISEASES: A POPULATION-BASED STUDY

Background

Individuals with autoimmune rheumatic diseases (ARDs) may be at greater risk of severe COVID-19 outcomes than individuals in the general population.

Objectives

This study assesses the risk of COVID-19-related hospitalization, intensive care unit (ICU) admission, and COVID-19-specific mortality in patients with ARDs compared to matched general population comparators.

Methods

We conducted a population-based cohort study, using administrative datasets from British Columbia, Canada (February 2020-August 2021). Among all test-positive SARS-CoV-2 adults, we used ICD codes to identify all individuals with an ARD: rheumatoid arthritis (RA), psoriasis/psoriatic arthritis (PsO/PsA), ankylosing spondylitis (AS), and systemic autoimmune rheumatic diseases (SARDs), including systemic lupus erythematosus (SLE), Sjogren’s syndrome, systemic sclerosis, myositis, and adult systemic vasculitides. Individuals with an ARD were matched 1:5 to general population test-positive SARS-CoV-2 individuals on age (± 5 years), sex, month/year of initial positive SARS-CoV-2 test, and health authority. Conditional logistic regression models adjusting for socioeconomic status, Charlson comorbidity index, hypertension, rural address, and number of previous COVID-19 PCR tests were performed to assess risk of COVID-19-related hospitalizations, ICU admissions, and COVID-19-specific mortality (mortality with primary ICD code for COVID-19).

Results

The risk of COVID-19-related hospitalization was significantly increased for patients with ARDs overall (aOR: 1.30) (Table 1). Within ARDs, the patient group at greatest risk of hospitalization was adult systemic vasculitides (aOR: 2.18). The risk of ICU admission was significantly increased for patients with ARDs overall (aOR: 1.30). Within ARDs, the patient group at greatest risk of ICU admission was those with AS (aOR: 2.03). The risk of COVID-19-specific mortality was significantly increased for patients with ARDs overall (aOR: 1.24). Within ARDs, the patient group at greatest risk of COVID-19-specific mortality was those with AS (aOR: 2.15).

Table 1.

Risk of severe COVID-19 outcomes among patients with ARDs

HospitalizationsICU admissionsCOVID-19-specific mortalityn (%)aOR (95% CI)n (%)aOR (95% CI)n (%)aOR (95% CI)ARDs (6,279)780 (12.4)1.30 (1.19, 1.43)225 (3.6)1.30 (1.11, 1.51)229 (3.7)1.24 (1.05, 1.47)ARD comparators (31,130)2,843 (9.1)1.00807 (2.6)1.00847 (2.7)1.00RA(2,067)321 (15.5)1.34 (1.15, 1.54)95 (4.6)1.30 (1.03, 1.65)103 (5.0)1.18 (0.92, 1.52)RA comparators (10,197)1,151 (11.3)1.00336 (3.3)1.00400 (3.9)1.00PsO/PsA(2,695)263 (9.8)1.17 (1.01, 1.37)65 (2.4)0.90 (0.68, 1.19)68 (2.5)0.93 (0.68, 1.26)PsO/PsA comparators (13,411)1,052 (7.8)1.00332 (2.5)1.00309 (2.3)1.00AS(529)51 (9.6)1.36 (0.95, 1.94)20 (3.8)2.03 (1.18, 3.50)13 (2.5)2.15 (1.02, 4.55)AS comparators (2,631)180 (6.8)1.0048 (1.8)1.0032 (1.2)1.00SARDs(1,118)168 (15.0)1.62 (1.32, 2.00)52 (4.7)1.74 (1.24, 2.44)49 (4.4)1.44 (1.00, 2.10)SARDs comparators (5,532)490 (8.9)1.00135 (2.4)1.00157 (2.8)1.00SLE(239)37 (15.5)1.88 (1.18, 3.00)11 (4.6)1.67 (0.75, 3.74)<50.85 (0.17, 4.29)SLE comparators (1,187)77 (6.5)1.0026 (2.2)1.0013 (1.1)1.00Sjogren’s(96)15 (15.6)2.07 (0.94, 4.58)<5*<5*Sjogren’s comparators (477)35 (7.4)1.0014 (2.9)1.0015 (3.2)1.00Myositis(30)5 (16.7)3.18 (0.69, 14.55)<5*<5*Myositis comparators (150)12 (8.0)1.00<51.007 (4.7)1.00Vasculitides(82)25 (30.5)2.18 (1.17, 4.05)8 (9.8)1.70 (0.70, 4.16)<5*Vasculitides comparators (404)64 (15.8)1.0021 (5.2)1.0016 (4.0)1.00

Results for systemic sclerosis not presented; sample size too small.

*Unable to be calculated (small sample size)

Conclusion

The risk of severe COVID-19 outcomes is increased in some ARDs, although magnitude differs across individual diseases. Strategies to mitigate risk, such as booster vaccination, prompt diagnosis, and early intervention with available therapies (e.g., oral antivirals) should be prioritized in these groups according to risk.

Acknowledgements

This work was supported by the Michael Smith Foundation for Health Research (grant COV-2020-1075) and the BC SUPPORT Unit (grant C19-PE-V3).

Disclosure of Interests

None declared

OP0039 RISK OF ARRHYTHMIA AMONG NEW USERS OF HYDROXYCHLOROQUINE: A LONGITUDINAL POPULATION-BASED COHORT STUDY ON NEWLY DIAGNOSED RHEUMATOID ARTHRITIS AND SYSTEMIC LUPUS ERYTHEMATOSUS PATIENTS

Background

Previous findings on hydroxychloroquine (HCQ) use and the risk of arrhythmia are contradictory and low-level evidence-based results. Additional research is required to evaluate the safety profile of HCQ to arrhythmia in managing rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE).

Objectives

To assess the association between HCQ initiation and risk of incident arrhythmia among newly diagnosed RA and SLE patients.

Methods

All patients with incident RA or SLE and no arrhythmic events or anti-arrhythmic medications and no HCQ use prior to disease index date in British Columbia, Canada, between January 1997 and March 2015 were identified using administrative databases. HCQ initiator and HCQ non-initiator groups were identified and matched 1:1 by propensity scores using baseline confounders on demographics including presence of RA or SLE disease and duration of disease prior to the index date of HCQ initiators or non-initiators, comorbidities, other medications, and healthcare utilization. Matching was done within the same calendar year to account for a potential secular trend in HCQ use and risk of arrhythmia. Outcomes were any new arrhythmias, atrial fibrillation, abnormal electrocardiogram including prolonged QT syndrome and conduction disorder, and other unspecified arrhythmias during follow-up. We used Cox proportional hazard models with death as a competing event to assess the association of HCQ initiation and the outcomes.

Results

We identified 11,518 HCQ initiators (10,655 RA and 863 SLE patients, mean ± SD age 55.9 ± 15.1 years, 76.1% female) and 11,518 HCQ non-initiators (10,639 RA and 879 SLE patients, mean ± SD age 56.0 ± 16.2 years, 76.4% female) after 1:1 propensity score matching. Over the mean follow-up of eight years, there were 1,610 and 1,646 incident arrhythmias in the HCQ initiator and non-initiator groups, respectively. The crude incidence rates of arrhythmia were 17.5, and 18.1 per 1,000 person-years, respectively. Cumulative risk of incident arrhythmia remained similar for both groups. (Figure 1). Adjusted hazard ratio (aHR) of incident arrhythmia from the Cox proportional hazard model for HCQ initiators was 0.99 (95% CI: 0.92-1.06) compared to non-initiators (Table 1). The corresponding aHRs for HCQ initiators in subtypes of arrhythmia – atrial fibrillation, abnormal electrocardiogram, and other unspecified arrhythmias were 0.95 (95% CI: 0.84-1.06), 1.04 (95% CI: 0.87-1.26), and 0.96 (95% CI: 0.86-1.08), respectively.

Table 1.

Incident arrhythmias of any type among RA and SLE patients initiating HCQ prescription compared with HCQ non-initiators

HCQ initiatorHCQ non-initiatorParticipants (number)11,51811,518Mean follow-up (years)8.007.89Events (number)1,6101,646Crude incidence rate per 1000 person-years17.4818.12Unadjusted HR (95% CI)0.98 (0.91-1.05)1.00 (reference)Adjusted# HR (95% CI)0.99 (0.92-1.06)1.00 (reference)

Abbreviations: HCQ, hydroxychloroquine; HR, hazard ratio.

#The multivariable Cox proportional hazard model was adjusted for baseline confounders on demographics, comorbidities, medications, and healthcare utilization.

Figure 1.

Cumulative risk of incident arrhythmias for HCQ initiators and non-initiators over the follow-up time.

Conclusion

There is no increased risk of any type of arrhythmia among new users of HCQ in RA and SLE patients. We believe the results of this large cohort study will add to the confidence with which HCQ can be used in RA and SLE management.

Disclosure of Interests

None declared.

[Consensus of experts on the oral health management and medical risk prevention for the patients with chronic airway diseases (2022 edition)]

Today, there is greater awareness on the association between oral diseases and respiration diseases after the outbreak of COVID-19. However, confusion regarding the oral health management and medical risk prevention for patients with chronic airway diseases has been remained among dental clinicians. Therefore, the dental experts of the Fifth General Dentistry Special Committee, Chinese Stomatological Association, combined with the experts of respiratory and critical care medicine, undertook the formation of consensus on the oral health management of patients with chronic airway diseases in order to help dental clinicians to evaluate medical risks and make better treatment decision in clinical practice. In the present consensus report, the relationship of oral diseases and chronic airway diseases, the oral health management and the treatment recommendations of patients with chronic airway diseases are provided.

[Consensus of experts on the medical risk prevention for the patients with cardiovascular diseases during dental treatment (2022 edition)]

With the aging process of population in the society, the prevalence of cardiovascular diseases (CVD) in China is increasing continuously and the number of dental patients with CVD is increasing gradually too. Due to the lack of guidelines for dental patients with CVD in our country, how to implement standardized preoperative evaluation and perioperative risk prevention remains a problem to be solved for dentists at present. The present expert consensus was reached by combining the clinical experiences of the expert group of the Fifth General Dentistry Special Committee, Chinese Stomatological Association and respiratory and cardiology experts in diagnosis and treatment for CVD patients, and by systematically summarizing the relevant international guidelines and literature regarding the relationship between CVD and oral diseases and the diagnosis and treatment of dental patients with heart failure, hypertension and antithrombotic therapy. The consensus aims to provide, for the dental clinicians, the criteria on diagnosis and treatment of CVD in dental patients in China so as to reduce the risk and complications, and finally to improve the treatment levels of dental patients with CVD in China.

A 25 Immune-Related Gene Pair Signature Predicts Overall Survival in Cervical Cancer

Mounting evidence suggests that the tumor microenvironment plays an important role in the occurrence and development of cancer, with immune system dysfunction being closely related to malignant cancers. We aimed to screen immune-related genes (IRGs) to generate an IRG pair (IRGP)-based prognostic signature for cervical cancer (CC). Datasets were obtained from The Cancer Genome Atlas and Gene Expression Omnibus databases and used as training and validation cohorts, respectively. Using the ImmPort database, IRGs in control and CC samples were compared, and differentially expressed genes were identified to construct an IRGP prognostic signature. Based on this analysis, 25 IRGPs were identified as important factors for the prognosis of CC. Univariate and multivariate Cox regression analyses further showed that the IRGP signature was an independent prognostic factor of overall survival. In summary, we successfully constructed an IRGP prognostic signature of CC, providing insights into immunotherapy for CC.

[Application of oral fluid in SARS-CoV-2 nucleic acid and antibody detection]

This study aimed to explore the application value of new biological specimen oral fluid in SARS-CoV-2 nucleic acid and antibody detection. Oral fluid and paired respiratory and blood specimens from 7 confirmed cases of two COVID-19 cluster epidemic were collected in Beijing from October to November 2021. SARS-CoV-2 virus and IgG antibody were detected by real time PCR kits and serum antibody detection reagents, and SARS-CoV-2 IgG antibody in oral fluids was detected by a new established method of magnetic particle chemiluminescence. The results showed that the nucleic acid amplification test of SARS-CoV-2 on nasopharyngeal swabs, throat swabs and oral fluid specimens from 3 confirmed cases of COVID-19 was positive, among which the Ct value for ORF1a/b and N gene of oral fluid samples in 2 cases was close to that of throat swab, and the Ct value of oral fluid sample for 1 case was higher than that of throat swab. The complete genome sequence of one oral fluid specimen was obtained, which belonged to the VOC/Delta variant strain. The SARS-CoV-2 IgG antibodies of the paired oral fluid and serum were all positive, and the S/CO values of oral fluid were all lower than those of serum. The series of oral fluid results showed that SARS-CoV-2 IgG antibody level increased from 11 to 32 days after the onset of the disease.

Use of real-time artificial intelligence in detection of abnormal image patterns in standard sonographic reference planes in screening for fetal intracranial malformations

OBJECTIVES

To develop and validate an artificial intelligence system, the Prenatal ultrasound diagnosis Artificial Intelligence Conduct System (PAICS), to detect different patterns of fetal intracranial abnormality in standard sonographic reference planes for screening for congenital central nervous system (CNS) malformations.

METHODS

Neurosonographic images from normal fetuses and fetuses with CNS malformations at 18-40 gestational weeks were retrieved from the databases of two tertiary hospitals in China and assigned randomly (ratio, 8:1:1) to training, fine-tuning and internal validation datasets to develop and evaluate the PAICS. The system was built based on a real-time convolutional neural network (CNN) algorithm, You Only Look Once, version 3 (YOLOv3). An image dataset from a third tertiary hospital was used to further validate, externally, the performance of the PAICS and to compare its performance with that of sonologists with different levels of expertise. Furthermore, a prospective video dataset was employed to evaluate the performance of the PAICS in a real-time scan scenario. The diagnostic accuracy, sensitivity, specificity and area under the receiver-operating-characteristics curve (AUC) were calculated to assess the performance of the PAICS and to compare this with the performance of sonologists with different levels of experience.

RESULTS

In total, 43 890 images from 16 297 pregnancies and 169 videos from 166 pregnancies were used to develop and validate the PAICS. The system achieved excellent performance in identifying 10 types of intracranial image pattern, with macro- and microaverage AUCs, respectively, of 0.933 (95% CI, 0.798-1.000) and 0.977 (95% CI, 0.970-0.985) for the internal validation image dataset, 0.902 (95% CI, 0.816-0.989) and 0.898 (95% CI, 0.885-0.911) for the external validation image dataset and 0.969 (95% CI, 0.886-1.000) and 0.981 (95% CI, 0.974-0.988) in the real-time scan setting. The performance of the PAICS was comparable to that of expert sonologists in terms of macro- and microaverage accuracy (P = 0.863 and P = 0.775, respectively), sensitivity (P = 0.883, P = 0.846) and AUC (P = 0.891, P = 0.788), but required significantly less time (0.025 s per image for PAICS vs 4.4 s for experts, P < 0.001).

CONCLUSIONS

Both in the image dataset and in the real-time scan setting, the PAICS achieved excellent diagnostic performance for various fetal CNS abnormalities. Its performance was comparable to that of experts, but it required less time. A CNN algorithm can be trained to detect fetal CNS abnormalities. The PAICS has the potential to be an effective and efficient tool in screening for fetal CNS malformations in clinical practice. © 2021 International Society of Ultrasound in Obstetrics and Gynecology.

Exogenous citric acid enhances drought tolerance in tobacco (Nicotiana tabacum)

Organic acids play a pivotal role in improving plant response to long-term drought stress. External application of organic acids has been reported to improve drought resistance in several species. However, whether organic acids have similar effects in tobacco remains unknown. A screening study of the protective function of organic acids in tobacco and understanding the underlying molecular mechanism would be useful in developing a strategy for drought tolerance. Several physiological and molecular adaptations to drought including abscisic acid, stomatal closure, reactive oxygen species homeostasis, amino acid accumulation, and drought-responsive gene expression were observed by exogenous citric acid in tobacco plants. Exogenous application of 50 mm citric acid to tobacco plants resulted in higher chlorophyll content, net photosynthesis, relative water content, abscisic acid content and lower stomatal conductance, transpiration and water loss under drought conditions. Moreover, reactive oxygen species homeostasis was better maintained through increasing activity of antioxidant enzymes and decreasing hydrogen peroxide content after citric acid pretreatment under drought. Amino acids involved in the TCA cycle accumulated after external application of citric acid under drought stress. Furthermore, several drought stress-responsive genes also dramatically changed after application of citric acid. These data support the idea that external application of citric acid enhances drought resistance by affecting physiological and molecular regulation in tobacco. This study provides clear insights into mechanistic details of regulation of amino acid and stress-responsive gene expression by citric acid in tobacco in response to drought, which is promising for minimizing growth inhibition in agricultural fields.

Sensitive and Selective Detection of Clenbuterol in Meat Samples by a Graphene Quantum Dot Fluorescent Probe Based on Cationic-Etherified Starch

The use of clenbuterol (CLB) in large quantities in feedstuffs worldwide is illegal and potentially dangerous for human health. In this study, we directly prepared nitrogen-doped graphene quantum dots (N-GQDs) by a one-step method using cationic-etherified starch as raw material without pollution, which has the advantages of simple, green, and rapid synthesis of N-GQDs and high doping efficiency of nitrogen elements, compared with the traditional nitrogen doping method of reacting nitrogen source raw material with quantum dots. The N-GQDs synthesized by cationic etherification starch with different substitution degrees (DSs) exhibit good blue-green photoluminescence, good fluorescence stability, and water solubility. By comparing the fluorescence emission intensity of the two methods, the N-GQDs prepared by this method have higher fluorescence emission intensity and good fluorescence stability. Based on the static quenching mechanism between CLB and N-GQDs, a fluorescent probe was designed to detect CLB, which exhibited a wide linear range in the concentration range of 5 × 10⁻¹⁰~5 × 10⁻⁷ M (R² = 0.9879) with a limit of detection (LOD) of 2.083 × 10⁻¹³ M. More excitingly, the N-GQDs fluorescent probe exhibited a satisfactory high selectivity. Meanwhile, it can be used for the detection of CLB in chicken and beef, and good recoveries were obtained. In summary, the strategic approach in this paper has potential applications in the detection of risky substances in the field of food safety.

Cartilage tissue engineering: From proinflammatory and anti‑inflammatory cytokines to osteoarthritis treatments (Review)

Osteoarthritis (OA), one of the most common joint diseases, is characterized by fibrosis, rhagadia, ulcers and attrition of articular cartilage due to a number of factors. The etiology of OA remains unclear, but its occurrence has been associated with age, obesity, inflammation, trauma and genetic factors. Inflammatory cytokines are crucial for the occurrence and progression of OA. The intra-articular proinflammatory and anti-inflammatory cytokines jointly maintain a dynamic balance, in accordance with the physiological metabolism of articular cartilage. However, dynamic imbalance between proinflammatory and anti-inflammatory cytokines can cause abnormal metabolism in knee articular cartilage, which leads to deformation, loss and abnormal regeneration, and ultimately destroys the normal structure of the knee joint. The ability of articular cartilage to self-repair once damaged is limited, due to its inability to obtain nutrients from blood vessels, nerves and lymphatic vessels, as well as limitations in the extracellular matrix. There are several disadvantages inherent to conventional repair methods, while cartilage tissue engineering (CTE), which combines proinflammatory and anti-inflammatory cytokines, offers a new therapeutic approach for OA. The aim of the present review was to examine the proinflammatory factors implicated in OA, including IL-1β, TNF-α, IL-6, IL-15, IL-17 and IL-18, as well as the key anti-inflammatory factors reducing OA-related articular damage, including IL-4, insulin-like growth factor and TGF-β. The predominance of proinflammatory over anti-inflammatory cytokine effects ultimately leads to the development of OA. CTE, which employs mesenchymal stem cells and scaffolding technology, may prevent OA by maintaining the homeostasis of pro- and anti-inflammatory factors.

Green synthetic nitrogen-doped graphene quantum dot fluorescent probe for the highly sensitive and selective detection of tetracycline in food samples

Tetracycline (TC) is a broad-spectrum antibiotic. When humans consume too much food containing tetracycline residues, it can be a serious health hazard. Therefore, it is essential to develop a strategy to detect TC. In this study, we prepared light blue-green luminescent nitrogen-doped graphene quantum dots (N-GQDs) by a hydrothermal method using the natural products potato straight-chain starch and urea as precursors; the fluorescence quantum yield of the prepared N-GQDs was 5.2%. We investigated the detection of tetracycline (TC) by this N-GQD fluorescent sensor based on the internal filtration effect (IFE) of TC on N-GQDs. The reaction is green, simple and no other contaminating products are present. A good linear relationship was established between the relative fluorescence intensity ratio of the system and the logarithm of the TC concentration of 2.5 × 10⁻¹⁰ to 5 × 10⁻⁶ M (R² = 0.9930), with a detection limit of 9.735 × 10⁻¹³ M. The method has been used to analyze TC in three real food samples (whole milk, skim milk, honey) with low detection limits (3.750 × 10⁻¹¹ to 2.075 × 10⁻⁹ M), wide linear range, and satisfactory recoveries of 93.80–109.20% were obtained. In conclusion, the proposed method is a green, rapid, highly sensitive and selective method for the detection of tetracycline in real food samples, demonstrating the potential application of N-GQDs in food detection.

Tetracycline (TC) is a broad-spectrum antibiotic.

Efficacy of Bifidobacterium animalis subsp. lactis, BB-12® on infant colic - a randomised, double-blinded, placebo-controlled study

To evaluate the administration of Bifidobacterium animalis subsp. lactis, BB-12^® (BB-12) on infant colic in breastfed infants, a double-blind, placebo-controlled randomised study was conducted in Chengdu, China from April 2016 to October 2017 with 192 full-term infants less than 3 months of age and meeting the ROME III criteria for infant colic. After a 1-week run-in the infants were randomly assigned to receive daily BB-12 (1×10⁹ cfu/day) or placebo for 3 weeks. Crying/fussing time were recorded using a 24 h structured diary. The primary endpoint was the proportion of infants achieving a reduction in crying and fussing time of ≥50% from baseline. Parent's/caregiver's health related quality of life was measured using a modified PedsQL^™ 2.0 Family Impact Module and immunological biomarkers were evaluated from faecal samples at baseline and after the 21-day intervention. The percentage of infants achieving a reduction in the daily crying/fussing time ≥50% after the 21-day intervention was significantly higher in the infants supplemented with BB-12 (P<0.001). The mean number of crying episodes was significantly reduced in the BB-12 group compared to the placebo group (10.0±3.0 to 5.0±1.87 vs 10.5±2.6 to 7.5±2.8, respectively) (P<0.001) and the mean daily sleep duration was markedly increased from baseline to end of intervention in the BB-12 group compared to the infants in the placebo group (60.7±104.0 vs 31.9±102.7 min/day, respectively) (P<0.001). The faecal levels of human beta defensin 2, cathelicidin, slgA, calprotectin and butyrate were statistically higher in the BB-12 group compared to the placebo group after the 21-day intervention. At the end of the intervention the parent's/caregiver's physical, emotional and social functioning scores were significantly higher for the BB-12 group compared to the placebo group (all P<0.05). Supplementation of BB-12 is effective in reducing crying and fussing in infants diagnosed with infant colic.

The miR-1906 mimic attenuates bone loss in osteoporosis by down-regulating the TLR4/MyD88/NF-κB pathway

In this study, the ability of microRNA-1906 (miR-1906) to attenuate bone loss in osteoporosis was evaluated by measuring the effects of a miR-1906 mimic and inhibitor on the cellular toxicity and cell viability of MC3T3-E1 cells. Bone marrow-derived macrophage (BMM) cells were isolated from female mice, and tartrate-resistant acid phosphatase signalling was performed in miR-1906 mimic-treated, receptor-activated nuclear factor kappa-B (NF-κB) ligand (RANKL)-induced osteoclasts. In-vivo, osteoporosis was induced by ovariectomy (OVX). Rats were treated with 500 nmol/kg of the miR-1906 mimic via intrathecal administration for 10 consecutive days following surgery. The effect of the miR-1906 mimic on bone mineral density (BMD) in OVX rats was observed in the whole body, lumbar vertebrae and femur. Levels of biochemical parameters and cytokines in the serum of miR-1906 mimic-treated OVX rats were analysed. The mRNA expression of toll-like receptor 4 (TLR4), myeloid differentiation primary response 88 (MyD88), p-38 and NF-κB in tibias of osteoporotic rats (induced by ovariectomy) was observed using quantitative reverse-transcription polymerase chain reaction. Treatment with the miR-1906 mimic reduced cellular toxicity and enhanced the cell viability of MC3T3-E1 cells. Furthermore, osteoclastogenesis in miR-1906 mimic-treated, RANKL-induced osteoclast cells was reduced, whereas the BMD in the miR-1906 mimic-treated group was higher than in the OVX group of rats. Treatment with the miR-1906 mimic also increased levels of biochemical parameters and cytokines in the serum of ovariectomised rats. Finally, mRNA expression levels of TLR4, MyD88, p-38 and NF-κB were lower in the tibias of miR-1906 mimic-treated rats than in those of OVX rats. In conclusion, the miR-1906 mimic reduces bone loss in rats with ovariectomy-induced osteoporosis by regulating the TLR4/MyD88/NF-κB pathway.

Arthroscopic Treatment of Acetabular Rim Fracture after Traumatic Posterior Hip Dislocation: A Case Series Study

Objective

To investigate the clinical and radiographic short‐term results of arthroscopic treatment for posterior labrum tears with an attached bony fragment after traumatic posterior hip dislocation.

Methods

Between July 2014 and May 2019, a consecutive series of nine patients diagnosed with a posterior labrum tear with an attached bony fragment after traumatic posterior hip dislocation were treated by hip arthroscopic techniques. The patients had been injured in traffic accidents (n = 6) or high falls (n = 3). All patients were provided primary treatment at the emergency department of our institution, and then were transferred to our department for arthroscopy. Demographic data (e.g. gender, age, etc), intraoperative findings, the preoperative and postoperative multiple clinical scores and radiological results were subsequently assessed. Visual analogue scale for pain (VAS) and modified Harris hip scores (mHHSs) were measured and compared before surgery, and at the last follow‐up.

Results

A total of nine patients were enrolled, all of them were male, with a mean age at surgery of 32.2 ± 5.6 years (range, 22–65 years). The patients were followed‐up for an average of 26.5 ± 4.1 (range, 24 to 50 years). During the arthroscopic surgery, all patients had labral tears with posterior acetabular rim fracture. All patients had loose osteochondral fragments. Five had partial or complete tears of ligamentum teres. Two patients had osteochondral damage. Two had capsular rupture. Postoperative X‐ray films and three dimension computed tomography (3D‐CT) showed satisfactory reduction of posterior acetabular wall fractures. The mHHS before surgery and at 1 year and 2 years after surgery were 51.8 ± 4.3, 81.8 ± 2.0 and 87.5 ± 1.9 respectively; VAS scores were 5.6 ± 0.5, 1.3 ± 0.3 and 0.7 ± 0.3 respectively. As compared with the condition before surgery, there was a significant improvement in the mHHS and VAS scores at 1 year and 2 years after surgery (P < 0.01). There was no significant improvement in the mHHS and VAS scores between 1 year and 2 years after surgery (P < 0.05). At the final follow‐up, all patients had regained full range of motion (ROM) and were satisfied with the results. None of the patients showed signs of heterotopic ossification, avascular necrosis or progression of osteoarthritis of the hip joint.

Conclusion

Traumatic dislocation is accompanied by a variety of intra‐articular hip joint pathologies. Managing posterior acetabular rim fracture after traumatic posterior hip dislocation using arthroscopic reduction and fixation with anchors is a safe and minimally invasive option and delays the progression of traumatic osteoarthritis.

A New Method of Isolation of Mouse Renal Primary Tubular Epithelial Cells

Kidney diseases are becoming an emerging public health problem. In order to further explore the etiology of various kidney diseases, we improved the methods of isolation of primary cultures of mouse renal tubular epithelial cells. At the first stage, the kidneys were perfused with collagenase solution. To this end, the superior mesenteric artery, celiac artery and thoracic aorta were ligated and perfusion was performed through the abdominal aorta. Then, the cells were isolated ex vivo and their integrity, purity, viability, and concentration were evaluated. The proposed cost-effective and simple method provides high purity and high concentration of primary renal epithelial cells for molecular biology studies of the kidneys.

Bioleaching of tellurium from mine tailings by indigenous Acidithiobacillus ferrooxidans

Tellurium (Te) is a scarce and valuable metalloid, which can be found in some mine tailings. In this work, an indigenous Acidithiobacillus ferrooxidans strain was used to leach Te from mine tailings collected in the Shimian Te mine region, China. Under the optimized conditions of initial pH of 2·0, pulp density of 4% and temperature of 30°C, 47·77% of Te can be dissolved after 24 days of bioleaching. The leaching of Te by different systems such as bioleaching, Ferric ion (Fe(III)) leaching and acid leaching was compared. The results showed that the leaching behaviour of Te is similar to that of sulphur in sulphide minerals, that is, Fe(III) first oxidizes telluride (Te(-II)) in minerals to elemental Te, and then elemental Te can be oxidized by bacteria to Te(IV) and Te(VI). Besides, it was also showed by scanning electron microscope observation and Fourier transform infrared spectroscopy analysis of the ore sample before and after bioleaching that some bedded structure covered on the surface of the ore after bioleaching acting as a reaction compartment, and the changing of active groups indicated a possible attachment between bacteria and ore. There is an indirect mechanism involved in bioleaching of Te.

[Epidemiological characteristics of Chlamydia pneumoniae in cases with acute respiratory infection in Beijing, 2015-2019]

Objective: To analyze the epidemiological characteristics of Chlamydia pneumoniae infection among patients with acute respiratory infection in Beijing from 2015 to 2019. Methods: The epidemiological data of acute respiratory infection patients from 35 sentinel hospitals in Beijing were collected by the respiratory pathogen surveillance system in Beijing. The clinical samples were collected to detect Chlamydia pneumoniae, and the sequence of the VD4 region of the ompA gene in positive samples was analyzed. Results: From January 2015 to December 2019, the overall positive rate of Chlamydia pneumoniae among patients with acute respiratory infection in Beijing was 0.34% (129/37 460). The positive rate of Chlamydia pneumoniae generally increased in March, reaching the peak in May, and started to drop in July, with a duration of about 5-8 months. The epidemic season in different years fluctuated by 1-2 months. The positive monthly rate of Chlamydia pneumoniae was no less than 0.30% in every epidemic season. The positive rate of Chlamydia pneumoniae was the highest in the 5-44 years old group and the highest in 10-14 year-olds. The risk of Chlamydia pneumoniae infection increased with age in patients younger than 25 years old and decreased in those older one aged than 25 years of age. The positive rates in male and female patients were 0.33% (68/20 830) and 0.37% (61/16 528), respectively, and there was no significant difference between the two groups (χ²=0.486, P=0.486). The positive rate of Chlamydia pneumoniae in patients with common pneumonia was higher than that in patients with upper pneumonia and severe pneumonia (χ²=36.797, P<0.01). Other respiratory pathogens were also detected in the Chlamydia pneumoniae samples, and the top four pathogens appeared as Haemophilus influenzae (15 cases), Streptococcus pneumoniae (13 cases), Rhinovirus (8 cases), and Stenotrophomonas maltophilia (7 cases). 101 strains of 129 Chlamydia pneumoniae positive samples were identified as type A by sequencing. Conclusions: The annual epidemic pattern of Chlamydia pneumoniae in Beijing, is unimodal, and the epidemic season generally appears from March to July. The seasonal characteristics of Chlamydia pneumoniae in Beijing can be used for the differential diagnosis of Chlamydia pneumoniae from other respiratory pathogens. Chlamydia pneumoniae is most common in people aged 5-44 years, and the primary genotype is type A. People aged 10-44 years old suffer the highest incidence. If the nucleic acid positive rate of Chlamydia pneumoniae exceeds 0.30% for two consecutive months, the high prevalence period of Chlamydia pneumoniae can be preliminarily expected. Chlamydia pneumoniae infection has a higher probability of progressing to severe pneumonia from general pneumonia.

[Clinical characteristics of patients infected with Chlamydia pneumoniae in Beijing from 2015 to 2019]

Objective: To aralyze the clinical characteristics of Chlamydia pneumoniae infection in Beijing. Methods: Based on Beijing Respiratory Pathogen Surveillance System, acute respiratory infection patients were recruited from 35 different types of sentinel hospitals in Beijing. Their epidemiological and clinical data were systematically collected and clinical specimens were also obtained. Nuclear acid testing was performed for 30 types of respiratory pathogens (including Chlamydia pneumoniae). The identified patients of Chlamydia pneumoniae infection were divided into two groups, the acute upper respiratory tract infection (AURI) group and pneumoniae group. The differences in clinical characteristics, laboratory examination and prognosis were compared by using independent sample t test, Mann-Whitney U test, χ² test or Fisher's exact probability test. Results: A total of 119 patients of Chlamydia pneumoniae infection were included, including 12 patients in the AURI group and 107 patients in pneumoniae group. Chlamydia pneumoniae infection mainly occurred in people aged from 5 to 44 years, accounting for 81.5% (97/119). The three most common clinical symptoms were cough (92.4%, 110/119), fever (88.8%, 95/107), and sputum production (76.5%, 91/119). White blood cell counts increased in 39.3% (46/117) of patients. Neutrophile granulocyte proportion increased in 39.7% (46/116) of patients. Platelet count increased in 36.9% (41/111) of patients. An increase of the creatine kinase MB isoenzyme (CKMB) was observed in 12 pneumonia patients (24.5%, 12/49). Radiological examination showed that 90.6% (87/105) of patients in the pneumoniae group had pulmonary parenchymal changes; the lesion occurred most commonly in the lower right lung lobe (34.3%, 36/105) and the lower left lung lobe (27.6%, 29/105). Although 73.8% (79/107) of patients in the pneumoniae group were hospitalized, no case received intensive care unit or mechanical ventilation. As to outcomes, one patient developed respiratory failure and 6 patients suffered myocardial injury. No death was observed in this study. The median days of hospitalization and course of illness for pneumonia patients M(P₂₅,P₇₅) were 10.0 (7.0, 13.0) days and 18.0 (13.5, 22.0) days, respectively. Conclusion: Generally, Chlamydia pneumoniae infections in Beijing from 2015 to 2019 were mild, and the main clinical manifestations were cough, fever and sputum. However, most patients in the pneumoniae group caused by Chlamydia pneumoniae still required hospitalization but with a better outcome.

Autophagy induction regulates aquaporin 3-mediated skin fibroblasts aging

BACKGROUND

Long- and short-term ultraviolet (UV) exposure have distinct biological effects on human fibroblasts.

OBJECTIVES

This study aimed to elucidate the underlying mechanisms of the biological effects of UV exposure on human skin fibroblasts.

METHOD

We subjected human skin fibroblast cells with or without AQP3, DEDD, or Beclin1 manipulation to UVA treatment and evaluated autophagy and senescence/aging in them.

RESULTS

Short-term UVA irradiation induced autophagy and upregulated AQP3 but not senescence, whereas long-term UVA irradiation inhibited autophagy, AQP3, and senescence/aging in vitro and in vivo. Silencing AQP3 abolished short-term UVA irradiation-induced autophagy and led to cellular senescence, whereas AQP3 overexpression partially rescued the senescence and autophagy inhibition induced by long-term UVA exposure in vitro. Mechanistically, the transcription factor JUN was found to bind to the AQP3 promoter to activate its transcription following short-term UVA exposure. Subsequently, AQP3 interacted with DEDD to induce its ubiquitination-mediated degradation and promote autophagy, and bound to Beclin1 to directly activate autophagy. Finally, autophagy induced by AQP3 overexpression robustly prevented UVA-induced senescence/aging in vitro and in vivo.

CONCLUSIONS

Thus, our study indicates that AQP3 controls skin fibroblasts photoaging by regulating autophagy and represents a potential target for future interventions against skin aging.

[Explore the value of whole exome sequencing in early diagnosis for children with language delay/disorder]

Objective: To evaluate the utility of whole-exome sequencing (WES) in early diagnosis for children with language delay/disorder. Methods: Children with language delay/disorder who were admitted to the Department of Health Care, Children's Hospital Affiliated to the Capital Pediatric Institute from January 2019 to December 2020 were analyzed retrospectively. Based on informed consent, the peripheral blood of the children and their parents was collected for WES. Combining the clinical phenotypes of the children, the candidate variants, including single nucleotide variants (SNVs) and copy number variations (CNVs), were selected for validation and family segregation analysis using Sanger sequencing, real-time PCR or CNV-Seq. The pathogenicity of variants was evaluated based on ACMG guideline following with finial genetic diagnosis. Based on whether genetic diagnosis was achieved or not, 125 children with comprehensive examination of the Children Neuropsychological and Behavioral Scale(CNBS-R2016) were sub-grouped (positive/negative group), and the total scores and the detailed scores of five developmental sections (gross motor, fine motor, adaptive ability, language and social behavior ability) between two subgroups were compared. Results: A total of 165 children with language delay/disorder were recruited, including 109 males and 56 females. The ratio of boys to girls was 1.95∶1.The age of the children was (3.2±1.2) years old, the median age was 3.0 years. 45 children carry disease-related pathogenic/likely pathogenic variants, including 36 SNVs and 9 CNVs. The genetic diagnostic yield of this cohort was 27.3% (45/165). The inheritance analysis for core family members showed de novo variant accounted for 86% of genetic diagnosis (31/36). The positive diagnosis rate in girls was 45% (25/56), which was significantly higher than that in boys (18.3%, 20/109, χ²=12.171, P<0.05). There was no significant difference in the rate of positive diagnosis among all age groups (χ²=4.349, P>0.05). Interestingly, the scores of gross motors of positive group were significantly lower than that of negative group (61.5 vs. 69.4, t=-2.610, P<0.05). Otherwise, no significant difference was seen between two groups(t=-0.933, -1.298, -0.114, -0.214, all P>0.05). Conclusions: Language delay/disorder has complex genetic heterogeneity. WES has important application value in early etiological diagnosis for children with language delay/disorder.