Advances in flexible weak-light detectors based on perovskites:preparation,optimization,and application

Photodetectors with weak-light detection capabilities play an indispensable role in various crucial fields such as health monitors,imaging,optical communication,and etc.Nevertheless,the detection of weak light signals is often severely interfered by multiple factors such as background light,dark noise and circuit noise,making it difficult to accurately capture signals.While traditional technologies like silicon photomultiplier tubes excel in sensitivity,their high cost and inherent fragility restrict their widespread application.Against this background,perovskite materials have rapidly emerged as a research focus in the field of photodetection due to their simple preparation processes and exceptional optoelectronic properties.Not only are the preparation processes of perovskite materials straightforward and cost-effective,but more importantly,they can be flexibly integrated into flexible and stretchable substrates.This characteristic significantly compensates for the shortcomings of traditional rigid electronic devices in specific application scenarios,opening up entirely new possibilities for photodetection technology.Herein,recent advances in perovskite light detection technology are reviewed.Firstly,the chemical and physical properties of perovskite materials are discussed,highlighting their remarkable advantages in weak-light detection.Subsequently,the review systematically organizes various preparation techniques of perovskite materials and analyses their advantages in different application scenarios.Meanwhile,from the two core dimensions of performance improvement and light absorption enhancement,the key strategies of improving the performance of perovskite weak-light photodetectors are explored.Finally,the review concludes with a brief summary and a discussion on the potential challenges that may arise in the further development of perovskite devices.

Detecting Pre and Early Retinal Changes in Patients with Type 2 Diabetes Mellitus Using Optical Coherence Tomography Angiography

Background: Studies conducted previously indicated that gradual vascular changes in diabetic retinopathy (DR) include reduction in retinal vascular density and choroidal thickness. One device that can be used to detect these early changes is optical coherence tomographic angiography (OCTA). Objective: To detect the pre and early diabetic retinal and choroidal microvascular changes in patients with type 2 diabetes mellitus using OCTA. Methods: A total of 188 eyes were included in the study that was conducted at Zhongnan Hospital of Wuhan University Ophthalmology Department. Participants were divided into three groups: controls (90 eyes), pre-DR (70 eyes) and early-DR (28 eyes). We evaluated the changes in vascular density of deep capillary plexus (DCP), intermediate capillary plexus (ICP), superficial vascular complex (SVP), choroidal thickness (CT) and choroidal vascular index (CVI). Results: Vessel density (VD) of deep capillary plexus (DCP) and intermediate capillary plexus (ICP) at 3 × 3 mm was not significant. However, superficial vascular plexus (SVP), was significant in superior quadrant, p = 0.033. In DCP layer at 6 × 6 mm, significant difference was noted superiorly, p = 0.023 and ANOVA p = 0.033. However, ICP layer showed significant changes temporaly and inferiorly in 1 - 3 mm and 1 - 6 mm retinal rings, p Conclusion: Our results reveal that although there were no clinical manifestations in the control group and the pre-DR group, changes in retinal and choroidal blood flow density had already occurred in the pre-DR group through OCTA detection, suggesting that early detection of the lesions provides an objective basis to prevent further retinal microvascular damage. Using OCTA parameters at 3 × 3 mm, 6 × 6 mm and 15 × 12 mm scan radius at different layers of the retina and choroid, we are able to detect early retinal microvascular and choroidal changes in patients with pre-DR and early-DR thereby saving the costs of dealing with advanced diabetic eye disease. OCTA therefore becomes a fundamental tool for the non-invasive diagnosis and prognosis of DR.

Polymer-based nanoparticulate solid dispersions prepared by a modified electrospraying process

A modified electrospraying process is exploited to enhance the dissolution profiles of a poorly water-soluble drug. With polyvinylpyrrolidone (PVP) as a hydrophilic polymer matrix and ketoprofen (KET) as a model drug, polymer-drug composites in the form of nanoparticles were prepared and characterized. The surface morphologies, the physical status of the drug, and the drug-polymer interactions were studied using FESEM, DSC, XRD, and ATR-FTIR. FESEM observations demonstrated that the nanoparticles gradually decreased in size from 640 ± 350, to 530 ± 320, 460 ± 200 and 320 ± 160 nm as the KET content increased from 0, to 9.1%, 16.7% and 33.3% w/w, respectively. Results from DSC and XRD suggested that KET was distributed in the PVP matrix in an amorphous manner at the molecular level. This is thought to be due to their compatibility, arising through hydrogen bonding as demonstrated by ATR- FTIR spectra. In vitro dissolution tests showed that the nanoparticles released the incorporated KET within 1 min, evidencing markedly improved dissolution over pure KET and a KET-PVP physical mixture. Electrospraying can hence offer a facile route to develop new polymer composites for biomedical applications, in particular for improving dissolution rate of poorly water-soluble drugs.

Integrated nanoporous electroporation and sensing electrode array for total dynamic time-domain cardiomyocyte membrane resealing assessment

Intracellular electrophysiological research is vital for biological and medical research.Traditional planar microelectrode arrays(MEAs)have disadvantages in recording intracellular action potentials due to the loose cell-electrode interface.To investigate intracellular electrophysiological signals with high sensitivity,electroporation was used to obtain intracellular recordings.In this study,a biosensing system based on a nanoporous electrode array(NPEA)integrating electrical perforation and signal acquisition was established to dynamically and sensitively record the intracellular potential of cardiomyocytes over a long period of time.Moreover,nanoporous electrodes can induce the protrusion of cell membranes and enhance cell-electrode interfacial coupling,thereby facilitating effective electroporation.Electrophysiological signals over the entire recording process can be quantitatively and segmentally analyzed according to the signal changes,which can equivalently reflect the dynamic evolution of the electroporated cardiomyocyte membrane.We believe that the low-cost and high-performance nanoporous biosensing platform suggested in this study can dynamically record intracellular action potential,evaluate cardiomyocyte electroporation,and provide a new strategy for investigating cardiology pharmacological science.

Characteristics and main controlling factors of helium resources in the main petroliferous basins of the North China Craton

At present, the main controlling factors of helium accumulation is one of the key scientific problems restricting the exploration and development of helium reservoir. In this paper, based on the calculation results of He generation rate and the geochemical characteristics of the produced gas, both the similarities and differences between natural gas and He resources in the Bohai Bay, Ordos and the surrounding Songliao Basin are compared and analyzed, discussing the main controlling factors of helium resources in the three main petroliferous basins of the North China Craton. It is found that the three basins of Bohai Bay, Ordos and Songliao have similar characteristics of source rocks, reservoirs and cap rocks, that's why their methane resource characteristics are essentially the same. The calculated ~4He generation per cubic metamorphic crystalline basement in the three basins is roughly equivalent, which is consistent with the measured He resources, and it is believed that the ~4He of radiogenic from the crust is the main factor controlling the overall He accumulation in the three basins;there is almost no contribution of the mantle-derived CH_4, which suggests that the transport and uplift of mantle-derived ~3He carried by the present-day magmatic activities along the deep-large faults is not the main reason for the mantle-derived ~3He mixing in the basins. Combined with the results of regional volcanic and geophysical studies,it is concluded that under the background of the destruction of North China Craton, magma intrusion carried a large amount of mantle-derived material and formed basic volcanic rocks in the Bohai Bay Basin and Songliao Basin, which replenished mantle-derived ~3He for the interior of the basins, and that strong seismic activities in and around the basins also promoted the upward migration of mantle source ~3He. This study suggests that the tectonic zone with dense volcanic rocks in the Cenozoic era and a high incidence of historical strong earthquakes history may be a potential area for helium resource exploration.

LKMT:Linguistics Knowledge-Driven Multi-Task Neural Machine Translation for Urdu and English

Thanks to the strong representation capability of pre-trained language models,supervised machine translation models have achieved outstanding performance.However,the performances of these models drop sharply when the scale of the parallel training corpus is limited.Considering the pre-trained language model has a strong ability for monolingual representation,it is the key challenge for machine translation to construct the in-depth relationship between the source and target language by injecting the lexical and syntactic information into pre-trained language models.To alleviate the dependence on the parallel corpus,we propose a Linguistics Knowledge-Driven MultiTask(LKMT)approach to inject part-of-speech and syntactic knowledge into pre-trained models,thus enhancing the machine translation performance.On the one hand,we integrate part-of-speech and dependency labels into the embedding layer and exploit large-scale monolingual corpus to update all parameters of pre-trained language models,thus ensuring the updated language model contains potential lexical and syntactic information.On the other hand,we leverage an extra self-attention layer to explicitly inject linguistic knowledge into the pre-trained language model-enhanced machine translation model.Experiments on the benchmark dataset show that our proposed LKMT approach improves the Urdu-English translation accuracy by 1.97 points and the English-Urdu translation accuracy by 2.42 points,highlighting the effectiveness of our LKMT framework.Detailed ablation experiments confirm the positive impact of part-of-speech and dependency parsing on machine translation.

Improved genome annotation of Brassica oleracea highlights the importance of alternative splicing

Brassica oleracea has been developed into many important crops,including cabbage,kale,cauliflower,broccoli and so on.The genome and gene annotation of cabbage(cultivar JZS),a representative morphotype of B.oleracea,has been widely used as a common reference in biological research.Although its genome assembly has been updated twice,the current gene annotation still lacks information on untranslated regions(UTRs)and alternative splicing(AS).Here,we constructed a high-quality gene annotation(JZSv3)using a full-length transcriptome acquired by nanopore sequencing,yielding a total of 59452 genes and 75684 transcripts.Additionally,we re-analyzed the previously reported transcriptome data related to the development of different tissues and cold response using JZSv3 as a reference,and found that 3843 out of 11908 differentially expressed genes(DEGs)underwent AS during the development of different tissues and 309 out of 903 cold-related genes underwent AS in response to cold stress.Meanwhile,we also identified many AS genes,including BolLHCB5 and BolHSP70,that displayed distinct expression patterns within variant transcripts of the same gene,highlighting the importance of JZSv3 as a pivotal reference for AS analysis.Overall,JZSv3 provides a valuable resource for exploring gene function,especially for obtaining a deeper understanding of AS regulation mechanisms.

Predictive model for non-malignant portal vein thrombosis associated with cirrhosis based on inflammatory biomarkers

BACKGROUND Portal vein thrombosis(PVT),a complication of liver cirrhosis,is a major public health concern.PVT prediction is the most effective method for PVT diagnosis and treatment.AIM To develop and validate a nomogram and network calculator based on clinical indicators to predict PVT in patients with cirrhosis.METHODS Patients with cirrhosis hospitalized between January 2016 and December 2021 at the First Hospital of Lanzhou University were screened and 643 patients with cirrhosis who met the eligibility criteria were retrieved.Following a 1:1 propensity score matching 572 patients with cirrhosis were screened,and relevant clinical data were collected.PVT risk factors were identified using the least absolute shrinkage and selection operator(LASSO)and multivariate logistic regression analysis.Variance inflation factors and correlation matrix plots were used to analyze multicollinearity among the variables.A nomogram was constructed to predict the probability of PVT based on independent risk factors for PVT,and its predictive performance was verified using a receiver operating characteristic curve(ROC),calibration curves,and decision curve analysis(DCA).Finally,a network calculator was constructed based on the nomograms.RESULTS This study enrolled 286 cirrhosis patients with PVT and 286 without PVT.LASSO analysis revealed 13 variables as strongly associated with PVT occurrence.Multivariate logistic regression analysis revealed nine indicators as independent PVT risk factors,including etiology,ascites,gastroesophageal varices,platelet count,D-dimer,portal vein diameter,portal vein velocity,aspartate transaminase to neutrophil ratio index,and platelet-to-lymphocyte ratio.LASSO and correlation matrix plot results revealed no significant multicollinearity or correlation among the variables.A nomogram was constructed based on the screened independent risk factors.The nomogram had excellent predictive performance,with an area under the ROC curve of 0.821 and 0.829 in the training and testing groups,respectively.Calibration curves and DCA revealed its good clinical performance.Finally,the optimal cutoff value for the total nomogram score was 0.513.The sensitivity and specificity of the optimal cutoff values were 0.822 and 0.706,respectively.CONCLUSION A nomogram for predicting PVT occurrence was successfully developed and validated,and a network calculator was constructed.This can enable clinicians to rapidly and easily identify high PVT risk groups.

Does astrocytic L-lactate enhance cognition through myelination?

Introduction:Astrocytes,the predominant glial cell in the brain,play a vital role in a plethora of central nervous system functions.They are the major storage site of glycogen in the central nervous system.They produce L-lactate by glycogenolysis and glycolysis which is then transported to neurons(Magistretti and Allaman,2018).Multiple evidence using diverse behavioral paradigms,such as fear conditioning,conditioned place avoidance,rat gambling task(RGT),and flavor-place paired associate(PA)learning suggest that L-lactate has a beneficial effect on various aspects of cognition(Wang et al.,2017;Akter et al.,2023b).While the molecular mechanisms underlying the cognitive benefits of L-lactate are still emerging,it is well-established that astrocytic L-lactate can be used as an energy substrate by neurons and can induce N-methyl-D-aspartate receptor-dependent plasticity-driven gene expression during cognition(Magistretti and Allaman,2018).Additionally,recent evidence has revealed more roles of L-lactate which include myelination,neuronal mitochondrial biogenesis,and antioxidant defense(Sanchez-Abarca et al.,2001;Ichihara et al.,2017;Akter et al.,2023a,b).Myelin in the central nervous system is a specialized lipid-rich membrane formed by oligodendrocytes.

Life's essential 8 and risk of subclinical atherosclerosis progression: a prospective cohort study

BACKGROUND Previous studies have demonstrated the benefits of ideal cardiovascular health(CVH) in reducing cardiovascular risk.However,its role in subclinical atherosclerosis(SA) progression remains unclear.We aim to examine the association of CVH,estimated by the American Heart Association's new Life's Essential 8(LE8),with the progression of SA.METHODS This prospective cohort study was conducted among 972 asymptomatic Chinese participants and followed up for5.7 years.The LE8 score(range,0–100) consisted of blood pressure,lipids,glucose,body mass index,smoking status,diet health,physical activity and sleep health was evaluated in 1998 and 2008–2009.Progression of SA was determined by carotid plaque and coronary artery calcification(CAC) in 2008–2009 and 2013–2014.Log-binomial regression model was used to estimate the association of LE8 score with SA progression.RESULTS Each 10 points increment in LE8 score was associated with 15.2%(RR:0.848,95% CI:0.797–0.902),17.7%(RR:0.823,95% CI:0.766–0.884) and 12.0%(RR:0.880,95% CI:0.845–0.916) lower risks of carotid plaque,CAC and overall SA progression,respectively.Compared with participants with non-ideal CVH at both visits,the participants with ideal CVH at both visits had39.1%(RR:0.609,95% CI:0.494–0.752),41.0%(RR:0.590,95% CI:0.456–0.764) and 29.7%(RR:0.703,95% CI:0.598–0.825) lower risks of carotid plaque,CAC and overall SA progression,respectively.CONCLUSIONS Higher LE8 scores were associated with lower risks of SA progression.Besides,long-term maintenance of optimal CVH was more beneficial to prevent SA progression.

Colon signet-ring cell carcinoma with chylous ascites caused by immunosuppressants following liver transplantation:A case report

BACKGROUND Chylous ascites is caused by disruption of the lymphatic system,which is characterized by the accumulation of a turbid fluid containing high levels of triglycerides within the abdominal cavity.The two most common causes are cirrhosis and tuberculosis,and colon signer ring cell carcinoma(SRCC)due to the use of immunosuppressants is extremely rare in cirrhotic patients after liver transplantation,making it prone to misdiagnosis and missed diagnosis.CASE SUMMARY A 52-year-old man who underwent liver transplantation and was administered with immunosuppressants for 8 months was admitted with a 3-month history of progressive abdominal distention.Initially,based on lymphoscintigraphy and lymphangiography,lymphatic obstruction was considered,and cystellar chyli decompression with band lysis and external membrane stripping of the lymphatic duct was performed.However,his abdominal distention was persistent without resolution.Abdominal paracentesis revealed allogenic cells in the ascites,and immunohistochemistry analysis revealed adenocarcinoma cells with phenotypic features suggestive of a gastrointestinal origin.Gastrointestinal endoscopy was performed,and biopsy showed atypical signet ring cells in the ileocecal valve.The patient eventually died after a three-month follow-up due to progression of the tumor.CONCLUSION Colon SRCC,caused by immunosuppressants,is an unusual but un-neglected cause of chylous ascites.

Causal association between 731 immunocyte phenotypes and liver cirrhosis: A bidirectional two-sample mendelian randomization analysis

BACKGROUND Liver cirrhosis is a progressive hepatic disease whose immunological basis has attracted increasing attention.However,it remains unclear whether a concrete causal association exists between immunocyte phenotypes and liver cirrhosis.AIM To explore the concrete causal relationships between immunocyte phenotypes and liver cirrhosis through a mendelian randomization(MR)study.METHODS Data on 731 immunocyte phenotypes were obtained from genome-wide assoc-iation studies.Liver cirrhosis data were derived from the Finn Gen dataset,which included 214403 individuals of European ancestry.We used inverse variable weighting as the primary analysis method to assess the causal relationship.Sensitivity analyses were conducted to evaluate heterogeneity and horizontal pleiotropy.RESULTS The MR analysis demonstrated that 11 immune cell phenotypes have a positive association with liver cirrhosis[P<0.05,odds ratio(OR)>1]and that 9 immu-nocyte phenotypes were negatively correlated with liver cirrhosis(P<0.05,OR<1).Liver cirrhosis was positively linked to 9 immune cell phenotypes(P<0.05,OR>1)and negatively linked to 10 immune cell phenotypes(P<0.05;OR<1).None of these associations showed heterogeneity or horizontally pleiotropy(P>0.05).CONCLUSION This bidirectional two-sample MR study demonstrated a concrete causal association between immunocyte phenotypes and liver cirrhosis.These findings offer new directions for the treatment of liver cirrhosis.

Family functioning mediation in tic severity and quality of life for children with Tourette syndrome

BACKGROUND Tourette syndrome(TS)is recognized as a neurodevelopmental disorder profoundly influenced by familial factors,particularly family functioning.However,the relationship among family functioning,tic severity,and quality of life in individuals with TS during childhood and adolescence remains unclear.We hypothesized that family functioning plays a role in the association between the severity of TS and quality of life in children.AIM To determine the role of family functioning in the relationship between TS severity and quality of life.METHODS This study enrolled 139 children(male/female=113/26)with TS.We assessed tic severity using the Yale Global Tic Severity Scale,quality of life via the Tourette Syndrome Quality of Life Scale,and family functioning through the Family Assessment Device.Our analysis focused on correlating these measures and exploring the mediating role of family functioning in the relationship between tic severity and quality of life.Additionally,we examined if this mediating effect varied by gender or the presence of comorbidity.RESULTS We found that family communication dysfunction had a significant mediating effect between tic severity and both psychological symptoms(indirect effect:Β=0.0038,95%confidence interval:0.0006-0.0082)as well as physical and activities of daily living impairment(indirect effect:Β=0.0029,95%confidence interval:0.0004-0.0065).For vocal tic severity,this mediation was found to be even more pronounced.Additionally,in male participants and those without attention deficit hyperactivity disorder,the mediating effect of family communication dysfunction was still evident.CONCLUSION Our study highlights the impact of family functioning on the tic severity and the quality of life in children.This relationship is influenced by gender and comorbid conditions like attention deficit hyperactivity disorder.

Developing a Machine Vision System Equipped with UV Light to Predict Fish Freshness Based on Fish-Surface Color

This study assessed the feasibility of developing a machine vision system equipped with ultraviolet (UV) light, using changes in fish-surface color to predict aerobic plate count (APC, a standard freshness indicator) during storage. The APC values were tested and images of the fish surface were taken when fish were stored at room temperature. Then, images’ color-space conversion among RGB, HSV, and L*a*b* color spaces was carried out and analyzed. The results revealed that a* and b* values from the UV-light image decreased linearly during storage. A further regression analysis of these two parameters with APC value demonstrated a good exponential relationship between the a* value and the APC value (R2 = 0.97), followed by the b* (R2 = 0.85). Therefore, our results suggest that the change in color of the fish surface under UV light can be used to assess fish freshness during storage.

Correlation Analysis Between Changes of D-Dimer Level and Rheumatoid Arthritis Complicated with Interstitial Lung Disease

Objective:To explore the correlation between the change of D-dimer level and rheumatoid arthritis complicated with interstitial lung disease.Methods:From January 2022 to February 2024,20 rheumatoid arthritis patients complicated with interstitial lung disease(interstitial lung disease group),20 rheumatoid arthritis patients without interstitial lung disease(without interstitial lung disease group),and 20 healthy people(control group)in Xijing Hospital were selected for this study.The fasting venous blood of the three groups of subjects was collected and their D-dimer,C-reactive protein(CRP),rheumatoid factor(RF),and erythrocyte sedimentation rate(ESR)were detected.Subsequently,the correlation between each index and rheumatoid arthritis complicated with interstitial lung disease was analyzed.Results:The D-dimer level of the interstitial lung disease group was significantly higher than the other two groups(P<0.05).The D-dimer level of the group without interstitial lung disease was significantly higher than the control group(P<0.05).CRP levels in the interstitial lung disease group and the group without interstitial lung disease were significantly higher than those of the control group(P<0.05).The ESR and RF levels of the interstitial lung disease group were significantly higher than the other two groups(P<0.05).The levels of ESR and RF levels of the group without interstitial lung disease were significantly higher than the control group(P<0.05).Conclusion:D-dimer levels of rheumatoid arthritis patients are higher than those of healthy individuals,and those complicated with interstitial lung disease present even higher levels.This finding shows that there is a correlation between D-dimer levels and rheumatoid arthritis with interstitial lung disease,which may facilitate the evaluation and diagnosis of this disease.

Effect of N-Acetylcysteine Combined with Lung Rehabilitation Therapy on Exercise Endurance and Quality of Life of Patients with Rheumatoid Arthritis-Related Interstitial Lung Disease

Objective:To explore the effect of N-acetylcysteine combined with lung rehabilitation therapy on exercise endurance and quality of life in patients with rheumatoid arthritis-related interstitial lung disease(RA-ILD).Methods:Fifty-six patients with RA-ILD admitted to Xijing Hospital from May 2022 to January 2024 were randomly divided into two groups:a non-rehabilitation group and a pulmonary rehabilitation group,with 28 patients in each group.Both groups received routine treatment.Additionally,the non-rehabilitation group received N-acetylcysteine treatment,while the lung rehabilitation group received lung rehabilitation treatment in addition to N-acetylcysteine.The improvement in exercise endurance and dyspnea between the two groups after treatment was compared and the quality of life of the patients was observed.Results:After treatment,the exercise endurance score in the lung rehabilitation group(335.67±45.29)was higher than that in the non-rehabilitation group(P<0.05).The dyspnea score in the lung rehabilitation group(0.72±0.16)was lower than that in the non-rehabilitation group(P<0.05).Additionally,FVC(3.18±0.58 L),FEV1(2.28±0.56 L),FEV1/FVC(69.69±5.56),and DLCO(60.53±5.92 mL/mmHg/min)were higher in the lung rehabilitation group compared to the non-rehabilitation group after treatment(P<0.05).Conclusion:Lung rehabilitation therapy combined with N-acetylcysteine treatment can effectively improve dyspnea symptoms,lung function,and exercise endurance in patients with RA-ILD.This approach helps to improve patient’s quality of life and is beneficial for their prognosis.

Study on the Application Effect of Enhanced Recovery After Surgery (ERAS) in Patients Undergoing Spinal Fracture Surgery

Objective:To study the application effect of the Enhanced Recovery After Surgery(ERAS)model in patients undergoing spinal fracture surgery.Methods:A randomized controlled trial was designed,and 86 patients undergoing spinal fracture surgery were randomly divided into the ERAS group and the conventional care group.Postoperative recovery outcomes of the two groups were compared.Results:The ERAS group showed better outcomes in terms of postoperative pain scores,activities of daily living,length of hospital stay,and adherence to rehabilitation training compared to the conventional care group,with shorter hospital stays and lower medical expenses(P<0.05).Conclusion:The ERAS model significantly improves the postoperative recovery quality of patients undergoing spinal fracture surgery,reduces hospital stay and medical costs,and increases patient satisfaction.

Analysis of an Output-Oriented Teaching Method in College English under the Second Language Acquisition Theory

In the context of economic globalization,English has become increasingly essential for students’communication and professional activities,necessitating higher proficiency in speaking and listening.The theory of second language acquisition posits that college English teaching can purposefully guide students’learning and facilitate unconscious language acquisition.By integrating an output-oriented teaching method,students are provided with opportunities to practice and apply English,thereby addressing the traditional issue of“separation of learning and use.”This paper examines the application value of the output-oriented teaching method in college English under the second language acquisition theory and proposes several strategies to enhance college English classroom teaching.The goal is to develop students’linguistic competence and improve their practical English skills.

Pregnancy Complicated with Acute Promyelocytic Leukemia: A Case Report and a Literature Review

Acute promyelocytic leukemia (APL) is a special subgroup of acute myeloid leukemia (AML). About 95% of the patients have specific chromosome translocation t (15 ≤ 17) (q22, q12). APL progresses rapidly and is characterized by extensive and severe bleeding and disseminated intravascular coagulation (DIC). Patients may present with severe clinical manifestation which is often caused by the occurrence of DIC in the early stages of the disease. Pregnancy complicated with APL is rare in the clinical setting. They have many complications, high mortality and are difficult to manage clinically. This case report describes a case of a primary pregnancy complicated with APL, in order to better understand how to manage such complex cases.

Risk factors for progression to acute-on-chronic liver failure during severe acute exacerbation of chronic hepatitis B virus infection

BACKGROUND Acute exacerbation in patients with chronic hepatitis B virus(HBV) infection results in different severities of liver injury. The risk factors related to progression to hepatic decompensation(HD) and acute-on-chronic liver failure(ACLF) in patients with severe acute exacerbation(SAE) of chronic HBV infection remain unknown.AIM To identify risk factors related to progression to HD and ACLF in compensated patients with SAE of chronic HBV infection.METHODS The baseline characteristics of 164 patients with SAE of chronic HBV infection were retrospectively reviewed. Independent risk factors associated with progression to HD and ACLF were identified. The predictive values of our previously established prediction model in patients with acute exacerbation(AE model) and the model for end-stage liver disease(MELD) score in predicting the development of ACLF were evaluated.RESULTS Among 164 patients with SAE, 83(50.6%) had compensated liver cirrhosis(LC),43 had progression to HD without ACLF, and 29 had progression to ACLF within 28 d after admission. Independent risk factors associated with progression to HD were LC and low alanine aminotransferase. Independent risk factors for progression to ACLF were LC, high MELD score, high aspartate aminotransferase(AST) levels, and low prothrombin activity(PTA). The area under the receiver operating characteristic of the AE model [0.844, 95%confidence interval(CI): 0.779-0.896] was significantly higher than that of MELD score(0.690, 95%CI: 0.613-0.760, P < 0.05) in predicting the development of ACLF.CONCLUSION In patients with SAE of chronic HBV infection, LC is an independent risk factor for progression to both HD and ACLF. High MELD score, high AST, and low PTA are associated with progression to ACLF. The AE model is a better predictor of ACLF development in patients with SAE than MELD score.