Development and Validation of a Prognostic Risk Score System for COVID-19 Inpatients:A Multi-Center Retrospective Study in China

Coronavirus disease 2019(COVID-19)has become a worldwide pandemic.Hospitalized patients of COVID-19 suffer from a high mortality rate,motivating the development of convenient and practical methods that allow clinicians to promptly identify high-risk patients.Here,we have developed a risk score using clinical data from 1479 inpatients admitted to Tongji Hospital,Wuhan,China(development cohort)and externally validated with data from two other centers:141 inpatients from Jinyintan Hospital,Wuhan,China(validation cohort 1)and 432 inpatients from The Third People’s Hospital of Shenzhen,Shenzhen,China(validation cohort 2).The risk score is based on three biomarkers that are readily available in routine blood samples and can easily be translated into a probability of death.The risk score can predict the mortality of individual patients more than 12 d in advance with more than 90%accuracy across all cohorts.Moreover,the Kaplan-Meier score shows that patients can be clearly differentiated upon admission as low,intermediate,or high risk,with an area under the curve(AUC)score of 0.9551.In summary,a simple risk score has been validated to predict death in patients infected with severe acute respiratory syndrome coronavirus 2(SARS-CoV-2);it has also been validated in independent cohorts.

Characteristic analysis of diffuse leptomeningeal glioneuronal tumor misdiagnosed as cryptococcal meningitis in adolescent female

Diffuse leptomeningeal glioneuronal tumor(DLGNT)in adolescent female is rare and easy to be misdiagnosed due to its nonspecificity.This article described the characteristics of an adolescent female DLGNT patient with no history of tumor whose first symptoms are headache and vision loss,and analyzed the causes why DLGNT is easy to be misdiagnosed as cryptococcal meningitis.Treatment remedies:the adolescent female presented with progressive exacerbations of headache,vomiting and vision loss after general treatment.Dynamic monitoring of routine biochemical changes in cerebrospinal fluid(CSF)found abnormal high CSF pressure and protein,repeated examination of antibodies and acid-fast bacilli were negative,and high-throughput pathogen gene examination excluded viral meningitis,tuberculous meningitis and other diseases.To save the optic nerve,the Ommaya capsule was implanted to reduce the intracranial pressure.After diagnostic antifungal treatment,the patient’s condition did not improve.To identify the etiology,extensive meningeal enhancement was eventually detected by enhanced magnetic resonance imaging(MRI),and highly atypical tumor cells were identified by repeated examination of fresh CSF cytology.Post treatment evaluating:for DLGNT,consult oncology.Meningeal biopsy and PET-CT(positron emission tomographycomputed tomography)examination were recommended,and intrathecal chemotherapy and whole-brain radiotherapy were performed according to the examination results.But the patient’s family refused to have a meningeal biopsy and asked to be released from the hospital.Conclusions:the adolescent female without a history of tumor can not rule out the disease,and cryptococcal meningitis also has meningeal enhancement.The gold standard for the diagnosis of DLGNT is to find cancer cells.There is no effective cure for DLGNT,the timely placement of Ommaya sac can significantly improve the quality of the patient’s life,and the active adoption of targeted therapy is expected to extend the patient’s survival.

Clinical features and literature review of Cogan’s syndrome with bilateral internal carotid artery occlusion

Cogan’s syndrome is rare.The purpose of this article is to describe a Cogan’s syndrome case characterized by bilateral internal carotid artery occlusion and to review the literature.Treatment remedies:we showed a patient with vertigo,nausea and retching,blurred vision,unclear speech.And the whole cerebral angiogram of the patient showed bilateral internal carotid artery occlusion without obvious neurological deficit.After differential diagnosis,compared with classic Cogan’s syndrome,granulomatous polyvasculitis(GPA),rheumatoid arthritis(RA),systemic lupus erythematosus(SLE),the patient was considered as Cogan’s syndrome.Post treatment evaluating:the patient did not significantly improve vertigo after vascular bypass therapy.Conclusions:Cogan’s syndrome may cause severe vascular occlusion.The patient had no clinical symptoms;and the chronic occlusion caused by vascular inflammation may be the reason,so that there was enough time for compensation.

持续释放蒙脱土插层杂化复合材料中的成骨微量元素促进骨再生

优化支架组分和结构以实现内源性成骨是骨组织工程中一项有前景的进展.本研究将蒙脱土作为一种增强相,以插层结构引入到多巴胺介导的仿生有机/无机杂化水凝胶中.通过蒙脱土-聚合物相互作用和多酚介导的多重反应改善了骨再生支架(HDC-HAp-MMT)的理化特性,增强了力学性能和抗降解能力.特别是,持续性释放的有益微量元素为成骨微环境提供了关键的成骨生化信号.该水凝胶在体外促进了骨髓间充质干细胞增殖和成骨分化.同时,在异位成骨模型中,显著增强了矿物沉积(30天后机械增强6.91倍);在原位兔颅骨修复实验中,实现了相对于天然骨80.94%的骨体积分数和85.89%的骨密度.该策略可能代表了一种新型的生物活性骨再生支架的制备方法.

Promoting interactions between cognitive science and large language models

Large language models(LLMs)have made unprecedented progress,demonstrating human-like language proficiency and an extraordinary ability to encode complex knowledge.The emergence of high-level cognitive capabilities in LLMs,such as in-context learning and complex reasoning,suggests a path toward the realization of artificial general intelligence(AGI).However,we lack scientific theories and tools to assess and interpret such an emergence of the advanced intelligence of LLMs.Artificial intelligence(AI)has been extensively applied in various areas of fundamental science to accelerate scientific research.

The effect of LyPRP/collagen composite hydrogel on osteogenic differentiation of rBMSCs

Although platelet-rich plasma(PRP)plays a significant role in the orthopedic clinical application,it still faces two major problems,namely,uncontrollable factors release,frequent preparation and extraction processes as well as the inconvenient form of usage.To overcome these shortcomings,freeze-dried PRP(LyPRP)was encapsulated into bioactive Col I hydrogel to induce osteogenic dif-ferentiation of rabbit bone marrow mesenchymal stem cells(rBMSCs).And PRP/Col I composite hydrogel was prepared as a control.Compared with Col I hydrogel,the introduction of platelets significantly improved the mechanical properties of hydrogels.Meanwhile,platelets were evenly distributed in the composite hydrogels network.The sustainable release of related factors in the composite hydrogels could last for more than 14days to maintain its long-term biological activity.Further cell experiments confirmed that PRP and LyPRP could effectively alleviate the contraction of collagen hydrogel in vitro,and promote the adhesion,proliferation and osteogenesis differentia-tion of rBMSCs.The results of osteogenic gene expression indicated that the 10%LyPRP/Col I composite hydrogel could facilitate the early expression of BMP-2 and late osteogenic associated protein formation with higher expression of alkaline phosphatase and Osteocalcin(OCN).These results might provide new insights for the clinical application of 10%LyPRP/Col I composite hydro-gel as practical bone repair injection.

Predicting Illness Severity and Short-Term Outcomes of COVID-19:A Retrospective Cohort Study in China

Introduction COVID-19,caused by SARS-CoV-2,is a highly contagious disease.1 By April 8,2020,more than 1,350,000 patients were diagnosed with COVID-19 globally,with more than 79,000 deaths worldwide attributable to the disease.2 Recent clinical data reported that mild and critical patients manifested different symptoms.Most of the mild patients with COVID-19 had symptoms such as fever,cough,and mild pneumonia,whereas the critical cases presented dyspnea,respiratory failure,sepsis,organ dysfunction,and even eventual death.

Clinical characteristics and vaccine effectiveness against SARS-CoV-2 Omicron subvariant BA.2 in the children

Dear Editor,The Omicron variant of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)has rapidly replaced the Delta variant as a dominating SARS-CoV-2 variant because of natural selection,which favors the variant with higher infectivity and stronger vaccine breakthrough ability.1 Among three lineages BA.1(B.1.1.529.1),BA.2(B.1.1.529.2),and BA.3(B.1.1.529.3)of Omicron,BA.2 is rising rapidly worldwide since January 2022 and become a new dominating“variant of concern”in China.2 With the current surge in Omicron in China,both the absolute number of children hospitalized with COVID-19 and the percentage of total COVID-19 hospitalizations have been boosting recently.Understanding the clinical characteristics of SARS-CoV-2 Omicron subvariant BA.2 in children and the protective effect of vaccines is of great help for epidemic prevention strategies.However,so far no sufficient experimental data have been reported about infectivity,disease severity,vaccine breakthrough capability,and antibody resistance from pediatric BA.2.