[Clinical characteristics of children with SARS-CoV-2 Omicron variant infection in Kunming]

Objective: To investigate the clinical characteristics of hospitalized children infected with the Omicron variant in Kunming after the withdrawal of non-pharmaceutical interventions (NPI) and analyze the risk factors of severe cases. Methods: Clinical data was retrospectively collected from 1 145 children with SARS-CoV-2 Omicron infection who were hospitalized in six tertiary grade A hospitals in Kunming from December 10th, 2022 to January 9th, 2023. According to clinical severity, these patients were divided into the general and severe SARS-CoV-2 groups, and their clinical and laboratory data were compared. Between-group comparison was performed using t-test, chi-square test and Mann-Whitney U test. Spearman correlation test and multivariate Logistic regression analysis were used to determine the risk factors of severe illness. Results: A total of 1 145 hospitalized patients were included, of whom 677 were male and 468 female. The age of these patients at visit was 1.7 (0.5, 4.1) years. Specifically, there were 758 patients (66.2%) aged ≤3 years at visit and 387 patients (33.8%) aged >3 years. Of these children, 89 cases (7.8%) had underline diseases and the remaining 1 056 cases (92.2%) had no combined diseases. Additionally, of all the patients, 319 cases (27.9%) were vaccinated with one or two doses of SARS-CoV-2 vaccine, 748 cases (65.3%) had acute upper respiratory tract infection (AURTI), and six cases died (0.5%). A total of 1 051 cases (91.8%) were grouped into general SARS-CoV-2 group and 94 cases (8.2%) were grouped into severe SARS-CoV-2 group. Compared with the general cases, the severe cases showed a lower rate of SARS-CoV-2 vaccination and younger median age, lower lymphocyte count, as well as proportions of CD8+T lymphocyte (36 cases (38.3%) vs. 283 cases (26.9%), 0.5 (2.6, 8.0) vs. 1.6 (0.5, 3.9) years, 1.3 (1.0, 2.7) ×109 vs. 2.7 (1.3,4.4)×109/L, 0.17 (0.12, 0.24) vs. 0.21 (0.15, 0.16), respectively, χ2=4.88, Z=-2.21,-5.03,-2.53, all P<0.05). On the other hand, the length of hospital stay, proportion of underline diseases, ALT, AST, creatine kinase isoenzyme, and troponin T were higher in the severe group compared to those in the general group ((11.6±5.9) vs. (5.3±1.8) d, 41 cases (43.6%) vs. 48 cases (4.6%), 67 (26,120) vs. 20 (15, 32) U/L, 51 (33, 123) vs. 44 (34, 58) U/L、56.9 (23.0, 219.3) vs. 3.6 (1.9, 17.9) U/L, 12.0 (4.9, 56.5) vs. 3.0 (3.0, 7.0) ×10-3 pg/L,respectively, t=-20.43, χ2=183.52, Z=-9.14,-3.12,-6.38,-3.81, all P<0.05). Multivariate regression analysis indicated that increased leukocyte count (OR=1.88, 95%CI 1.18-2.97, P<0.01), CRP (OR=1.18, 95%CI 1.06-1.31, P<0.01), ferritin (OR=1.01, 95%CI 1.00-1.00, P<0.01), interleukin (IL)-6 (OR=1.05, 95%CI 1.01-1.08, P=0.012), D-dimer (OR=2.56, 95%CI 1.44-4.56, P<0.01) and decreased CD4+T lymphocyte (OR=0.84, 95%CI 0.73-0.98, P=0.030) were independently associated with the risk of severe SARS-CoV-2 in hospitalized children with Omicron infection. Conclusions: After the withdrawal of NPI, the pediatric inpatients with Omicron infection in Kunming were predominantly children younger than 3 years of age, and mainly manifested as AURTI with relatively low rate of severe SARS-CoV-2 infection and mortality. Elevated leukocyte counts, CRP, ferritin, IL-6, D-dimer, and decreased CD4+T lymphocytes are significant risk factors for developing severe SARS-CoV-2 infection.

[Research progress on the relationship between dietary patterns and metabolic-associated fatty liver disease]

Globally, metabolic-asssociated fatty liver disease has become a significant health burden due to its complex pathogenesis, and there are no specific and effective therapeutic drugs to date. The onset and progression of metabolic-asssociated fatty liver disease is closely associated with improper dietary habits. The cornerstone to treat metabolic-asssociated fatty liver disease is weight loss through a well-balanced diet. This article summarizes and discusses the research progress at home and abroad in relationship to metabolic-asssociated fatty liver disease and dietary patterns such as the Mediterranean diet, the DASH diet, an energy-restricted balanced diet, a low fat diet, a low carbohydrate diet, a western diet, an animal food diet, a traditional diet, and others. In addition, it categorizes the effects of various dietary patterns on the prevention, treatment, or induction of several issues that need further metabolic-asssociated fatty liver disease research for subsequent reference.

MicroRNA-140-5p suppresses invasion and proliferation of glioma cells by targeting glutamate-ammonia ligase (GLUL)

Glutamine addiction is a major feature of glioma cells and plays an important role in its growth and proliferation. GLUL (glutamate-ammonia ligase), which catalyzes glutamate and ammonia to synthesize glutamine, plays a crucial role in tumor growth and proliferation. We attempt to determine a pathway that limits the growth of glioma by targeting GLUL and explore effective strategies blocking glutamine metabolism. We note that miRNAs mediate regulation of genes participating directly or indirectly in cancer cell metabolism. The regulatory roles of miRNAs on metabolic enzymes are widely discussed, however miRNAs regulation of glutamine metabolism by targeting GLUL in glioma has not yet been reported. Here, we examined both the expression and functions of GLUL in glioma cells. Findings indicated that the expression of GLUL was upregulated in high-grade compared to low-grade glioma cells. Knockdown of GLUL effectively inhibited proliferation, migration and invasion of glioma cells in vitro. Bioinformatics analyses, as well as dual-luciferase reporter assays, revealed that miR-140-5p bound to GLUL mRNA at the 3'-UTR location. Furthermore, the proliferation, migration and invasion of glioma cells were also repressed by miR-140-5p. Overall, these results showed that miR-140-5p exerted its inhibitory effects on proliferation, migration and invasion in glioma cells through downregulating GLUL. Thus, the miR-140-5p/GLUL axis may function as a potential target for glioma treatment.

[Early results of fenestrated endovascular aortic repair for the treatment of patients with thoracoabdominal pathologies]

Objective: To evaluate the early results of fenestrated endovascular aortic repair (FEVAR) using physician-modified stent grafts (PMSGs) for the treatment of patients with thoracoabdominal pathologies. Methods: Nineteen consecutive patients who underwent FEVAR using PMSGs between April 2012 and September 2017 were retrospectively reviewed. The modality of FEVAR technique was assessed, perioperative clinical data was recorded and the early results were evaluated. Results: Indications were thoracoabdominal aortic pathologies, including juxtarenal abdominal aortic aneurysm (JAAA) (n=12), chronic thoracoabdominal aortic dissection with aneurysmal dilatation (n=3), thoracoabdominal aortic aneurysm (TAAA) (n=1), infrarenal AAA with an accessory renal artery in the segment of the aneurysmal neck (n=2) and type Ⅰ endoleak after EVAR for AAA(n=1). Nineteen fenestrated stent grafts were deployed , including custom-made Cook Zenith fenestrated stent graft(n=1), home-made Cook Zenith TX2 fenestrated stent graft(n=6), home-made Cook Zenith TFFB fenestrated stent graft(n=9), home-made Cook Zenith Cuff fenestrated stent graft(n=2), home-made Gore C3 fenestrated stent graft(n=1). Mean duration for stent graft modification was 110 (90-140) min. Mean operative time was 268.0 (59.0-334.0) min, and fluoroscopy time was 66.0 (15.0-175.0) min. There were a total of 50 target vessels, of which 45 (95%) were stented. Bare metal stents were used in 28 vessels, and covered stents were used in 17 vessels. Technical success rate was 100%. No intraoperative target vessel loss was observed. Perioperative mortality was 5.3% (1/19). Endoleaks were persisted even after ballooning in five patients. A small type Ⅰ proximal endoleak and type Ⅲ endoleak were found in 2 and 1 patients, respectively. Type Ⅲ endoleak combined with type Ⅱ endoleak were observed in 2 patients. All the endoleaks were accepted and needed watching. In two patients, iliofemoral artery problems were resolved after local endarterectomy and stenting. Two patients presented renal deterioration postoperatively and recovered after the conservative therapy. Median length of stay was 6.6 (2.0-12.0)d. No early reintervention (<30 days) was performed. The mean duration of follow-up was 11.2 (2.0-41.0) months. One patient died 6 months after FEVAR due to advanced renal carcinoma. All target vessels remained patent except for one accessory artery occlusion. Conclusion: FEVAR using PMSGs may be a viable alternative for high-risk patients with thoracoabdominal pathologies.

[Preliminary study of endovascular aneurysm repair using fenestration on table for abdominal aortic aneurysm with short proximal neck]

Objective: To investigate the clinical value of endovascular aneurysm repair(EVAR) using fenestration on table for abdominal aortic aneurysm(AAA) with short proximal neck. Methods: A retrospective analysis of four cases with short proximal neck AAA from Aug. 2015 to May. 2016 of Tianjin Medical University General Hospital treated by EVAR using fenestration on table. Fenestrated stent-grafts were designed according to the preoperative computer tomography angiography(CTA) data. All cases underwent EVAR with the fenestrated stent-grafts on table to revascularize visceral branches. Results: FEVAR was performed in all of the 4 cases successfully. Device deploying success rate was 100%. No type Ⅰ endoleak was found in all of the 4 cases. Transient renal dysfunction occurred in two cases during 7 post-operative days and improved with the medical treatment. Mean follow-up period was 4.7 months(range, 1-9 months). CTA (3 cases) and ultrasonic imaging(1 case) were performed postoperatively. No endoleak was found around fenestrated stent graft and patency of visceral stent grafts were maintained in all of the 4 cases. Conclusion: EVAR using fenestration on table for short proximal neck AAA is safe and feasible, which expand the indication of EVAR for AAA, and the long-term safety and outcomes of this technique need to be assessed in the future.

Imaging of cardiac electrical excitation conduction

We present a multiple time windows beamformer (MTWB) method of solving the inverse problem of magnetic field and non-invasively imaging the cardiac electrical excitation conduction using the magnetocardiac signals acquired by a 61-channel superconducting quantum interference device (SQUID). The MTWB constructs spatial filters for each location in source space, one for each component of the source moment based on the distributed source model, and estimates the cardiac equivalent current sources. The output of spatial filters is the source strength estimated in three-dimensional space and the weight matrix calculated with magnetocardiac signals in multiple time windows. A signal subspace projection technique is used to suppress noise. Then, the characteristics of cardiac electrical excitation conduction among two healthy subjects and two coronary vessel stenosis (CVS) patients are extracted from reconstructed current sources with maximum strength at each instant during QRS complex and ST-T segment, and a series of two-dimensional cardiac electrical excitation conduction maps (EECM) are obtained. It is demonstrated that two healthy subjects are of similar and the stronger electrical activities than those of two CVS patients. This technique can be used as an effective tool for the diagnosis of heart diseases.

Inhibition of adipogenic differentiation of bone marrow mesenchymal stem cells by erythropoietin via activating ERK and P38 MAPK

We examined whether erythropoietin (EPO) can inhibit adipogenic differentiation of mesenchymal stem cells (MSCs) in the mouse bone marrow and its underlying mechanism. We separated and extracted mouse bone marrow MSCs and induced adipogenic differen-tiation using 3-isobutyl-1-methylxanthine, insulin, and dexamethasone. Different concentrations of EPO were added to the cells and observed by Oil Red O staining on the 20th day to quantitatively analyze the degree of cell differentiation. mRNA expression levels of peroxysome proliferator-activated receptor γ (PPARγ), CCAAT enhancer binding protein α, and adiponectin were analyzed by real-time quantitative polymerase chain reaction, and the activity of PPARγ, extracellular sig-nal-regulated kinase (ERK), and p38 mitogen-activated protein kinase (p38 MAPK) were determined by western blotting. EPO significantly inhibited adipogenic differentiation of MSCs after 20 days and reduced absorbance values by Oil Red O staining without affecting proliferation activity. EPO downregulated the mRNA expression of PPARγ, CCAAT enhancer binding protein α, fatty acid binding protein 4, and adiponec-tin during adipogenesis and increased protein phosphorylation of ERK, p38 MAPK, and PPARγ during differentiation. EPO downregulated the mRNA expression of PPARγ, CCAAT enhancer binding protein α, fatty acid binding protein 4, and adiponectin by increasing protein phosphor-ylation of ERK, p38 MAPK, and PPARγ during differentiation, which inhibited adipogenic differentiation of MSCs.

Percutaneous radiofrequency ablation of lung tumours: Results in first 100 consecutive patients

7714

Background: Treatment modalities for patients with primary and secondary lung malignancies who are not surgical candidates are limited. Radiofrequency ablation is a minimally invasive, lung sparing therapeutic alternative that may provide local disease control for these patients. The study reported our experience with first 100 consecutive patients who underwent radiofrequency ablation of their lung tumours. Methods: From November 2000 to December 2006, the clinical and treatment-related information regarding the 100 consecutive patients (58 males, mean age of 65 years) with 240 lung tumours treated by radiofrequency ablation were collected prospectively. Radiofrequency ablation was performed percutaneously under CT guidance with local anaethesiologic assistance and conscious sedation using a RITA Starbust XL electrode. The patients were hospitalized overnight and followed at one week, one month and then every three months with CT to evaluate treatment outcome and complications. Results: Five patients had primary lung carcinoma while the remaining patients had pulmonary metastases from extra-thoracic malignancies, with colorectal cancer being the most common primary site (68%), followed by renal cell carcinoma (8%) and uterine leiomyosarcoma (5%). The mean number of pulmonary lesions ablated was 2.4 per patient; the mean size of lesion ablated was 2.2 cm in diameter. Fifteen patients had second-time RFA; 4 patients underwent third- or fourth-time RFA for pulmonary recurrence. There was no post-procedural mortality and the overall morbidity rate was 42%. The most common complication was pneumothorax, which occurred in of 31% of procedures (n=39/127) with 20 (16%) requiring chest tube placement. After a median follow-up of 24 months (range 1 to 70 months), 72% of RFA treated lesions did not progress. The overall median disease-free interval was 13 months, with 1-, 3- and 5- year disease-free survival of 55%, 22% and 7% respectively. The overall median survival was 34 months with 1-, 3- and 5-year- survival of 85%, 49% and 33% respectively. Conclusions: Percutaneous radiofrequency ablation is an emerging therapy with promising results when surgical resection of pulmonary malignancy cannot be performed.

No significant financial relationships to disclose.

In vivo study on biocompatibility and bonding strength of hydroxyapatite-20vol%Ti composite with bone tissues in the rabbit

Biocompatibility and bonding strength of hydroxyapatite-20vol%Ti composite fabricated by hot-pressing technique with bone tissues in the rabbit were investigated by in vivo studies in comparison with those of Ti metal and dense HA ceramic. Although fibrous tissues formed at the interface between the composite and bone tissues at 3 weeks in vivo, bonding strength of the composite increases faster than that of dense HA after 4 weeks. At 3 months in vivo, bonding strength of the composite is higher than that of dense HA and exceeds 6.5 MPa. Moreover, as compared with the visible bonding interfaces between dense HA and new bones, the bonding interfaces for the composite cannot already be distinguished and the composite was osseointegrated fully with bone tissues into one bony body. The shear fracture of bonding strength test for the composite occurred in new bone zones near the interface, which indicates that bonding strength of the composite could even exceed the shear strength of new bones after 3 months in vivo. In conclusion, HA-Ti composite has better osteoconduction and osseointegration abilities than Ti metal and dense HA ceramic after 3 months in vivo and is a promising biomaterial for hard tissue replacement.

Effects of androgen supplementation therapy on partial androgen deficiency in the aging male: a preliminary study

OBJECTIVE

To assess the responses of a symptom complex related to partial androgen deficiency in the aging male (PADAM) to androgen supplementation.

SUBJECTS AND METHODS

Eighty-six men from five hospitals in Beijing aged 50-70 years with symptoms related to PADAM received oral testosterone undecanoate for 2 months, and the effects of the therapy were evaluated.

RESULTS

After treatment, the symptom scores were significantly improved (all p < 0.001). Serum levels of luteinizing hormone and follicle stimulating hormone were suppressed, and free testosterone and albumin-bound testosterone levels were elevated. However, they were not significantly different from the pretreatment values. Waist/hip ratio and blood pressure were markedly decreased, but no changes were found in serum levels of total cholesterol, triglyceride, albumin and prostate specific antigen.

CONCLUSIONS

Two months of treatment with oral testosterone undecanoate clearly improved the symptoms related to PADAM. No statistical relationship was found between symptom improvement and androgen levels. Androgen therapy for 2 months was beneficial to the waist/hip ratio and blood pressure, and no harm was done to the prostate gland or lipid metabolism.

Studies on plasma endothelin changes in varicocele patients

AIM

To investigate the possible role endothelin may play in the pathogenesis of varicocele and varicocele-induced infertility.

METHODS

In varicocele patients, radioimmunoassay is used to determine the blood endothelin concentration in the spermatic vein and the antecubital vein separately.

RESULTS

The blood endothelin concentration of the spermatic vein (66.8 +/- 23.5 pg/mL) was significantly higher (P < 0.05) than that of the antecubital vein (55.3 +/- 25.3 pg/mL). The endothelin concentration in the spermatic vein in Grade II varicocele patients was not significantly different from that in Grade III patients (P = 0.87).

CONCLUSION

The higher blood endothelin level in the spermatic vein may indicate the involvement of endothelin in the pathophysiology of varicocele and varicocele-induced infertility.

[Application of polymerase chain reaction in the diagnosis of gonococcal urethritis]

84 suspected patients with gonococcal urethritis were diagnosed by polymerase chain reaction (PCR). It was demonstrated that 28 patients (33.3%) were positive, and 56 (66.7%) negative. Of the PCR-positive patients, 18 showed secretions from the urethral tract, on which the bacterial stain and culture were carried out. The results indicate that 12 patients were positive, and 6 negative. There was no patient with positive stain and culture with PCR-negative. We conclude that PCR is more specific and sensitive than other routine methods in the diagnosis of gonococcal urethritis, especially of chronic infection.

Energy transfer kinetics in C-phycocyanin from cyanobacterium Westiellopsis prolifica studied by pump-probe techniques

The relaxation processes of C-phycocyanin at different aggregates have been investigated by pump-probe techniques. The lifetimes of ground state recovery measured at various wavelengths are analyzed by computer fitting of the kinetic data to a sum of three and four exponentials for monomers and trimers according to the nonlinear least-square principle, respectively. The shortest lifetime (about 56ps) is due to beta s----beta f transfer in one monomer, that decreases to 31ps in trimer due to the opening of new transfer channels. The second fastest component (about 151ps) in monomer is attributed tentatively to distribution of excitation energy between alpha and beta f chromophores, that decreases to about 117ps in trimer caused by redistribution of excitation energy between them. The two long-lived components (about 690ps and 1385ps for monomer, 620ps and 1320ps for trimer) from some kinds of heterogeneity in some chromophores, such as alpha and beta 1 chromophores which are emitting, show an equal amplitude ratio of 1:2 in both monomer and trimer.

[Measurement and clinical using of motor conduction latency time and motor conduction latency rate of facial nerve in health subjects and facial paralysis patients]

The motor conduction latency time (MCLT) and rate (MCLR) of facial nerve in 70 cases of health subjects and 60 cases of facial paralysis patients were measured using evoke EMG. The results showed that MCLT is below 4 ms and MCLR is above 25 m/sec in 70 cases of health subjects, while the MCLT is above 4 ms and MCLR is below 25 m/sec in 60 cases of facial paralysis patients. We have observed the difference of MCLR and MCLR on different age groups in health subjects. The results showed that MCLT is prolonged gradually and MCLR is gradual reduced after 50 years old groups. But the MCLT does not exceed 4 ms and MCLR is not slower than 25 m/sec. The results of this studies suggested that if MCLT is above 4 ms, and MCLR is below 25 m/sec, it is a index of facial nerve paralysis.

Recovery of sperm production following the cessation of gossypol treatment: a two-centre study in China

A number of variables were investigated in 46 men who had stopped taking gossypol for their predictive association with the degree and time of recovery of spermatogenesis. Thirty-nine (87%) of the men were azoospermic at cessation of gossypol treatment. In those with sperm present the geometric mean concentration and total sperm count were 8.3 X 10(6)/ml and 30.7 X 10(6), respectively. Twenty-eight men (61%) recovered to a defined threshold of spermatogenic function (sperm concentration greater than or equal to 20 X 10(6)/ml), with a median recovery time of 1.1 years. However, 18 men (39%) had not recovered to this degree of spermatogenic function after a median follow-up of 1.9 years and, of these, 10 (22%) remained azoospermic. The influence of individual baseline variables on the time to defined recovery was examined using Kaplan-Meier curves for groups and their joint effect by Cox's regression model. The failure of recovery was strongly associated with longer treatment, greater total dose of gossypol, smaller testicular volume, elevated FSH concentrations and, to a lesser extent, with greater body weight.

Follow-up of men in the recovery period immediately after the cessation of gossypol treatment

Variables in 46 men who had stopped taking gossypol in two centres in China were investigated for their predictive association with the degree and time of recovery of spermatogenesis. Thirty-nine (87%) were azoospermic at cessation of gossypol treatment. In those with sperm present the geometric mean concentration and total sperm count were 8.3 x 10(6)/ml and 30.7 x 10(6), respectively. Twenty-eight (61%) recovered to a defined threshold spermatogenic function (sperm concentration greater than or equal to 20 x 10(6)/ml), with median recovery time 1.1 years. However, 18 men (39%) had not recovered after a median follow-up of 1.9 years and, of these, 10 (22%) remained azoospermic. The failure of recovery was strongly associated with longer treatment, greater total dose of gossypol, smaller testicular volume, elevated FSH concentrations and, to a lesser extent, with greater body weight.

Dynamic study of serum gonadotrophin and testosterone levels in gossypol-treated men. Long term follow-up study of 60 cases

The endocrine effects of gossypol were studied in 26 men for 52 months before, during and after treatment. A further 34 subjects were studied after cessation of gossypol treatment. A control group of 60 age-matched volunteers were monitored for 1 year. No significant changes in testosterone levels were observed during the course of study. Serum LH levels were, however, significantly higher (P less than 0.001) during earlier phases of gossypol treatment and returned to normal after cessation of treatment except in 14 men with persistent disruption of spermatogenesis. In the latter, serum levels of LH and testosterone were significantly higher (P less than 0.001) than those found in normal subjects and significantly lower (P less than 0.05) than in those subjects in which spermatogenesis had recovered. Serum FSH levels did not rise during the first 8-9 months of treatment with gossypol, although azoospermia generally occurred within 76 days of commencing treatment. After 9 months of treatment, serum FSH levels rose gradually and remained significantly elevated (P less than 0.001) after cessation of treatment in both the azoospermic/oligospermic group and in the group in which spermatogenesis recovered. In the latter group the serum levels of FSH were correlated significantly with the sperm concentration.