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.

Antibiotics and immunotherapy in gastrointestinal tumors: Friend or foe?

The incidence of gastrointestinal (GI) tumors is increasing year by year, and its pathogenesis is closely related to the intestinal flora. At present, the use of antibiotics is very common in the clinic. And cancer patients with low immunity are vulnerable to all sorts of infections, such as respiratory tract infections and urinary tract infections. Moreover, cancer patients easily run into fever and neutropenia induced by myelosuppression. Therefore, antibiotics are used extensively and even overused in many conditions. However, because of the special anatomical location of the gastrointestinal tract, the antibiotic usage will bring changes to the intestinal flora. Besides, with the expanding popularity of immunotherapy, various factors affecting the efficacy of immune checkpoint inhibitors (ICIs) have been extensively explored, including cancer-associated inflammation and the local and systemic factors that lead to immunosuppression. Some biomarkers for ICIs, including the expression of PD-L1, tumor mutation load, and microbiota, also have been investigated, and many studies have confirmed that gut microbiota can affect the efficacy of immunotherapy. But further studies on the influence of antibiotics directly on immunotherapy are rare. In this review, we discuss the relationship between GI tumors and antibiotics, the current status of immunotherapy in GI tumors, and the influence of antibiotics on immunotherapy.

Imaging of hemorrhagic primary central nervous system lymphoma: A case report

BACKGROUND A primary central nervous system lymphoma(PCNSL)presenting with massive hemorrhage is a rare occurrence that is difficult to distinguish from a high-grade glioblastoma.Comprehensive descriptions of the imaging characteristics of such tumors have not yet been reported.Herein,we reported a case of a PCNSL with massive hemorrhage by presenting the imaging features of computed tomography(CT)imaging and structural and perfusion magnetic resonance imaging(MRI).CASE SUMMARY A 48-year-old man presented with headache lasting for 10 d.CT of the brain showed a round,heterogeneous,high-density lesion with surrounding edema in the right temporal lobe.For further diagnosis,a series of MRI examinations of the brain were subsequently performed,and a hemorrhagic lesion with ring-like enhancement was determined.The whole lesion was relatively hypoperfused on arterial spin labeling images.Surgical resection of the lesion and histopathological examination confirmed that the lesion was a diffuse large B-cell lymphoma with massive hemorrhage.CONCLUSION PCNSLs with hemorrhage occur very rarely,and structural and perfusion MRI examinations are requested exceedingly rarely.This case provided insight into some characteristics of a hemorrhagic lymphoma on CT and MRI examinations.Perfusion MRI examination may be useful for the differential diagnosis of PCNSLs and other brain tumors.

Will the 2022 compound heatwaveedrought extreme over the Yangtze River Basin become Grey Rhino in the future?

The increasingly frequent and severe regional-scale compound heatwave-drought extreme events(CHDEs),driven by global warming,present formidable challenges to ecosystems,residential livelihoods,and economic conditions.However,uncertainty persists regarding the future trend of CHDEs and their insights into regional spatiotemporal heterogeneity.By integrating daily meteorological data from observations in 1961-2022 and global climate models(GCMs)based on the Shared Socioeconomic Pathways,the evolution patterns of CHDEs were compared and examined among three sub-catchments of the Yangtze River Basin,and the return periods of CHDE in 2050s and 210Os were projected.The findings indicate that the climate during the 2022 CHDE period was the warmest and driest recorded in 1961-2022,with precipitation less than 154.5 mm and a mean daily maximum temperature 3.4°C higher than the average of 1981-2010,whereas the char-acteristics in the sub-catchments exhibited temporal and spatial variation.In July-August 2022,the most notable feature of CHDE was its extremeness since 1961,with return periods of~200-year in upstream,80-year in midstream,and 40-year in downstream,respectively.By 2050,the return periods witnessed 2022 CHDE would likely be reduced by one-third.Looking towards 2100,under the highest emission scenario of SSP585,it was projected to substantially increase the frequency of CHDEs,with return periods reduced to one-third in the upstream and downstream,as well as halved in the midstream.These findings provide valuable insights into the changing risks associated with forthcoming climate extremes,emphasizing the urgency of addressing these challenges in regional management and sustainable development.

Engineering in amino acid-functionalized double-layer heteropolymolybdates:from structural control to catalytic activity

A reexamination of the structural constraints on the amino acid-functionalized heteropolymolybdates has afforded four polyanions,namely the double-layer [(SeO_(3))_(2)Mo_(12)O_(36)(CH_(3)COO)_(3)]^(7-)(1),[(SeO_(3))_(1.3)(HPO_(3))_(0.7)Mo_(12)O_(36)(NH_(3)CH_(2)COO)_(3)]^(4-)(2),[(SeO_(3))_(1.4)(HPO_(3))_(0.6)Mo_(12)O_(36)(LNH_(3)C_(2)H_(3)OHCOO)_(3)]^(4-)(3),and the mono-layer [(SeO_(3))-Mo_6O_(18)(L-NH_(3)C_(2)H_(3)OHCOO)_(3)]^(2-)(4),which were crystallized as the hydrated ammonium salts.

Negative Association of Circulating MicroRNA-126 with High-sensitive C-reactive Protein and Vascular Cell Adhesion Molecule-1 in Patients with Coronary Artery Disease Following Percutaneous Coronary Intervention

Background： Percutaneous coronary intervention （PCI） causes endothelial damage, resulting in an inflammatory response with elevation of markers such as high-sensitive C-reactive protein （hs-CRP） and vascular cell adhesion molecule-1（VCAM-1）, which are associated with restenosis after PCI. Evidence suggests that microRNA-126 （miR-126） plays an important role in vascular inflammation, but its correlation with PCl-mediated inflammation has not been investigated. In this study, we investigated the effect of PCI on circulating miR-126 and inflammation markers such as hs-CRP and VCAM-1. Methods： We enrolled 130 patients with coronary artery disease （CAD） in the Second Hospital of Jilin University from October 2015 to December 2015. Among them, 82 patients with CAD, defined as at least one major epicardial vessel with 〉70% stenosis who planned to undergo PCI, were divided into acute coronary syndrome （ACS） group （46 patients） and stable angina （SA） group （36 patients）. Forty-eight patients confirmed by coronary angiography without PCI were used as controls. The plasmas of all patients were collected prior to PCI and at 30 min, 24 h, and 72 h after PCI. The plasma VCAM-1 and hs-CRP were detected by enzyme-linked immunosorbent assay, and the miR-126 was evaluated by quantitative reverse transcription-polymerase chain reaction. Results： Plasma concentrations of hs-CRP and VCAM-I in patients with either ACS （n = 46） or SA （n = 36） were significantly higher than in controls （n = 48） （P 〈 0.01） prior to PCI, and increased further at 24 h and 72 h after PCI, compared with prior PCI. Moreover, VCAM-1 was positively correlated with balloon time and pressure. In contrast, the plasma concentration of miR-126 was significantly lower in patients with CAD than in controls, and further decreased with time post-PCl. A negative correlation was observed between miR-126 and hs-CRP and VCAM-1 at 72 h after PCI. Conclusion： There was a negative correlation of miR-126 with the PCI-induced markers of inflammation such as hs-CRP and VCAM-1.

Containment of high-speed rotating disk fragments

Disk burst accidents sometimes happen in aeroengines.To avoid tragic consequences,aeroengine casings must have sufficient containment capability.Experiments and simulations need to be conducted to study the impact,distortion,and perforation caused by disk burst and which may give important clues to potential failure mechanisms.This paper presents some containment tests of high-speed rotating disk fragments,in which the original disks were burst into three equal fragments within a predetermined rotating speed range.The failure modes of the containment casing varied significantly with the thickness of the containment casing.Shearing,tearing,tensile fracture,and large plastic stretching deformation occurred in a thin-walled containment casing,while a thick-walled casing could contain disk fragments and withstand large plastic deformation.Numerical simulations were carried out to study the impact process and failure modes further.Good agreement was found between the results of the simulations and the tests.

Performance of the bronchoalveolar lavage fluid later-flow device test in the rapid diagnosis of non-neutropenic invasive pulmonary aspergillosis

To the Editor:A multicenter retrospective survey in China shows that the most common pulmonary fungal disease is pulmonary aspergillosis.[1]The diagnosis of invasive pulmonary aspergillosis(IPA)remains challenging because of the high false-negative and false-positive rate of galactomannan(GM)test.Domestic research reports that the IPA misdiagnosis rate can be as high as 73%.Besides,GM is time consuming,making the diagnosis delayed.

A modified constitutive model for FRP confined concrete in circular sections and its implementation with OpenSees programming

OpenSees is a well-recognized open source platform with high compatibility,and it has a well-developed fiber element method to cope with nonlinear structural analysis.Fiber reinforced polymer(FRP)confined concrete can effectively improve the seismic performance of concrete structures.However,sophisticated constitutive models for FRP confined concrete are not available in the current version of OpenSees.In this paper,after reviewing several typical FRP confined concrete constitutive models,a modified constitutive model for FRP confined concrete in circular sections was proposed based on Lam and Teng(2003)’s model with four main modifications including the determination of FRP rupture strain,ultimate condition,envelope shape,and hysteretic rules.To embed the proposed constitutive model into OpenSees is a practical solution for engineering simulation.Hence,the secondary development of OpenSees New UserMat was briefly demonstrated and a set of critical steps were depicted in a flow chart.Finally,with the numerical implementations of a series of FRP confined concrete members covering a wide range of load cases,FRP confinement types and geometric properties,the utility and accuracy of the proposed model compared with Lam and Teng(2003)’s model and new material secondary development in OpenSees were well validated.

MicroRNA-210 Plays a Critical Role in the Angiogenic Effect of Isoprenaline on Human Umbilical Vein Endothelial Cells via Regulation of Noncoding RNAs

Background：β-adrenoceptors play a crucial regulatory role in blood vessel endothelial cells.Isoprenaline （ISO,a β-adrenergic agonist） has been reported to promote angiogenesis through upregulation of vascular endothelial growth factor （VEGF） expression;however,the underlying mechanism remains to be investigated.It is widely accepted that certain noncoding RNAs,including microRNAs （miRNAs） and long noncoding RNAs （lncRNAs）,can regulate endothelial cell behavior,including their involvement in angiogenesis.Therefore,we aimed to investigate whether noncoding RNAs participate in ISO-mediated angiogenesis using human umbilical vein endothelial cells （HUVECs）.Methods：We evaluated VEGF-A messenger RNA （mRNA） and protein levels in ISO-treated HUVECs by quantitative real-time polymerase chain reaction and enzyme-linked immunosorbent assay,respectively.To establish whether noncoding RNAs are associated with ISO-mediated angiogenesis,we measured expression of the miRNAs miR-210,miR-21,and miR-l,as well as that of the lncRNAs growth arrest-specific transcript 5 （GAS5）,maternally expressed 3 （MEG3）,and metastasis-associated lung adenocarcinoma transcript 1 （MALAT1） in HUVECs exposed to ISO.Furthermore,to ascertain its importance in ISO-mediated angiogenesis,we constructed the HUVECs with overexpressing miR-210 and detected the subsequent expression of VEGF-A and noncoding RNAs.All statistical analyses were performed using SPSS 16.0 software.Intergroup comparisons were carried out by one-way analysis of variance.Results：VEGF-A mRNA levels were elevated in the ISO group （1.57 ± 0.09） compared to those in the control group （P 〈 0.01）.Moreover,concentrations of VEGF-A in culture supernatants significantly differed between the control （113.00 ± 19.21 pg/ml） and ISO groups （287.00 ± 20.27 pg/ml;P 〈 0.01）.Expression of miR-1,miR-21,and miR-210 was higher （3.89 ± 0.44,2.87 ± 087,and 3.33 ± 1.31,respectively） in ISO-treated cells than that in controls （P 〈 0.01）,whereas that of GAS5 and MEG3 （0.22 ± 0.10 and 0.58 ± 0.16,respectively） was lower as a result of ISO administration （P 〈 0.05）.There was no significant difference in the expression of MALAT1 between the groups.Interestingly,miR-210 overexpression heightened the levels of VEGF-A and miR-21 （5.87 ± 1.24 and 2.74 ± 1.15,respectively;P 〈 0.01） and reduced those of GAS5 and MEG3 （0.19 ± 0.01 and 0.09 ± 0.05,respectively;P 〈 0.01）.Conclusions：ISO-mediated angiogenesis was associated with altered expression of miR-210,miR-21,and the lncRNAs GAS5 and MEG3.The effects ofmiR-210 on the expression of VEGF-A and noncoding RNAs were similar to those of ISO,indicating that it might play an important role in ISO-mediated angiogenesis.

圆形纤维增强塑料缠绕混凝土柱在持续轴向压缩下的面向设计的模型分析（英文）

目的:在实际工程服役过程中,纤维增强塑料(FRP)约束混凝土柱在遭遇极限荷载前往往已经经历了长时间的轴压荷载作用。因此,相比其短期力学性能,本文旨在研究FPR约束混凝土柱在长期荷载作用后的力学性能。创新点:1.考虑长期轴压荷载作用,提出一种轴压作用下圆形截面FRP约束混凝土柱的长期变形分析模型;2.提出了长期轴压作用后的FRP约束混凝土本构模型,从本构关系的角度描述两个方面的影响机理。方法:运用混凝土和FRP徐变的长期变形分析迭代计算方法(图3)。结论:1.提出的长期变形分析模型实现了对FRP约束混凝土柱任意目标时刻的应力和应变状态的高效、准确预测;2.将提出的本构模型嵌入有限元软件中,有效地实现对长期轴压作用的考虑;3.基于Open Sees有限元软件,验证了长期变形分析模型和本构模型的有效性和准确性。