Liver injury in COVID-19:Detection,pathogenesis,and treatment

In the early December 2019,a novel coronavirus named severe acute respiratory syndrome coronavirus 2 was first reported in Wuhan,China,followed by an outbreak that spread around the world.Numerous studies have shown that liver injury is common in patients with coronavirus disease 2019(COVID-19),and may aggravate the severity of the disease.However,the exact cause and specific mechanism of COVID-associated liver injury needs to be elucidated further.In this review,we present an analysis of the clinical features,potential mechanisms,and treatment strategies for liver injury associated with COVID-19.We hope that this review would benefit clinicians in devising better strategies for management of such patients.

Effectiveness and safety of over-the-scope clip in closing perforations after duodenal surgery

BACKGROUND Endoscopic resection of duodenal subepithelial lesions(SELs)is a difficult procedure with a high risk of perforation.At present,dealing with perforation after endoscopic resection of duodenal SELs is still considered a great challenge.AIM To evaluate the effectiveness and safety of an over-the-scope clip(OTSC)in the treatment of perforation post-endoscopic resection of duodenal SELs.METHODS From May 2015 to November 2019,18 patients with perforation following endoscopic resection of duodenal SELs were treated with OTSCs.Data comprising the rate of complete resection,closure of intraprocedural perforation,delayed bleeding,delayed perforation,and postoperative infection were extracted.RESULTS The rate of complete removal of duodenal SELs and successful closure of the perforation was 100%.The median perforation size was 1 cm in diameter.Seventeen patients had minor intraoperative bleeding,while the remaining 1 patient had considerable amount of bleeding during the procedure.Seven patients had postoperative abdominal infections,of which 1 patient developed an abscess in the right iliac fossa and another patient developed septic shock.All 18 patients recovered and were discharged.No delayed bleeding or perforation was reported.The mean time taken to resume normal diet after the procedure was 6.5 d.The mean postoperative hospital stay was 9.5 d.No residual or recurrent lesions were detected during the follow-up period(15-66 mo).CONCLUSION Closing a perforation after endoscopic resection of duodenal SELs with OTSCs seems to be an effective and reasonably safe therapeutic method.

Clinical results of non-Descemet stripping endothelial keratoplasty

AIM： To investigate the impact of non-Descemet stripping endothelial keratoplasty（non-DSEK） on graft rejection rate,and its overall procedural effectiveness in patients.METHODS： Non-DSEK was performed on 65 eyes of 64 patients,and the procedural outcomes,including rejection episodes,failure and dislocation of the grafts,best corrected visual acuity（BCVA）,endothelial cell density（ECD）,and other complications,were analyzed retrospectively.RESULTS： Of the 65 eyes,63 recovered from bullous keratopathy with a clear cornea.The mean follow-up time was 26.4mo（range,6-84mo）.The mean BCVA improved from 1.70 log MAR preoperatively to 0.54 log MAR at 3mo,0.46 logM AR at 6mo,and 0.37 logM AR at 1y after surgery.The postoperative donor ECD of the 25 patients who successfully underwent specular microscopic examination was 1918±534 cells/mm^2（range,637 to 3056 cells/mm^2）,and the mean endothelial cell loss was 41.9% at 24 mo postoperatively.One eye developed secondary glaucoma and required regrafting via penetrating keratoplasty（PKP）.Another eye had postoperative graft failure due to rejection at 26 mo.Postoperative graft dislocation occurred in eight eyes.All of the eight dislocated grafts were reattached using air reinjection.CONCLUSION： Immunological graft rejection of the donor graft rarely occurs in non-DSEK.Therefore,non-DSEK is a safe,concise,and effective alternative to restore corneal decompensation when the Descemet membrane is disease-free.

New hope for esophageal stricture prevention:A prospective singlecentertrial on acellular dermal matrix

BACKGROUNDGiven the high incidence of esophageal cancer in China,an increasing number ofpatients there are undergoing endoscopic mucosal dissection(ESD).Although the5-year survival rate after ESD can exceed 95%,esophageal stricture,the mostcommon and serious postoperative complication,affects the long-term prognosisof patients and the quality of life.Autologous mucosal grafts have proven to besuccessful in preventing stricture after ESD for early esophageal cancer.AIMTo examine the viability of acellular dermal matrix(ADM)as an alternative to autologous mucosa for the prevention of stricture after ESD.METHODSThis is a prospective,single-center,controlled study.Consecutive patients who underwent ESD surgery and werewilling to undergo autologous mucosal transplantation were recruited between January 1 and December 31,2017.Consecutive patients who underwent ESD surgery and were willing to undergo ADM transplantation wererecruited between January 1 to December 31,2019.A final three-year follow-up of patients who receivedtransplants was conducted.RESULTSBased on the current incidence of esophageal stricture,the sample size required for both the autologous mucosalgraft group and the ADM group was calculated to be 160 cases.Due to various factors,a total of 20 patients withautologous mucosal grafts and 25 with ADM grafts were recruited.Based on the inclusion exclusion andwithdrawal criteria,9 patients ultimately received autologous mucosal grafts and completed the follow-up,while11 patients received ADM grafts and completed the follow-up.Finally,there were 2 cases of stenosis in theautologous mucosal transplantation group with a stenosis rate of 22.22%and 2 cases of stenosis in the ADMtransplantation group with a stenosis rate of 18.18%,with no significant difference noted between the groups(P=0.94).CONCLUSIONIn this prospective,single-center,controlled trial,we compared the effectiveness of autologous mucosatransplantation and ADM for the prevention of esophageal stricture.Due to certain condition limitations,we wereunable to recruit sufficient subjects meeting our target requirements.However,we implemented strict inclusion,exclusion,and withdrawal criteria and successfully completed three years of follow-up,resulting in valuableclinical insights.Based on our findings,we hypothesize that ADM may be similarly effective to autologousmucosal transplantation in the prevention of esophageal stricture,offering a comparable and alternative approach.This study provides a new therapeutic idea and direction for the prevention of esophageal stricture.

Role of ferroptosis in colorectal cancer

Colorectal cancer(CRC)is the second deadliest cancer and the third-most common malignancy in the world.Surgery,chemotherapy,and targeted therapy have been widely used to treat CRC,but some patients still develop resistance to these treatments.Ferroptosis is a novel non-apoptotic form of cell death.It is an iron-dependent non-apoptotic cell death characterized by the accumulation of lipid reactive oxygen species and has been suggested to play a role in reversing resistance to anticancer drugs.This review summarizes recent advances in the prognostic role of ferroptosis in CRC and the mechanism of action in CRC.

Wire and arc additive manufacturing of 4043 Al alloy using a cold metal transfer method

Cold metal transfer plus pulse(C+P)arc was applied in the additive manufacturing of 4043 Al alloy parts.Parameters in the manufacturing of the parts were investigated.The properties and microstructure of the parts were also characterized.Experimental results showed that welding at a speed of 8 mm/s and a wire feeding speed of 4.0 m/min was suitable to manufacture thin-walled parts,and the reciprocating scanning method could be adopted to manufacture thick-walled parts.The thin-walled parts of the C+P mode had fewer pores than those of the cold metal transfer(CMT)mode.The thin-and thick-walled parts of the C+P mode showed maximum tensile strengths of 172 and 178 MPa,respectively.Hardness decreased at the interface and in the coarse dendrite and increased in the refined grain area.

Cost-effective low-coverage whole-genome sequencing assay for the risk stratification of gastric cancer

BACKGROUND Gastric cancer(GC), a multifactorial disease, is caused by pathogens, such as Helicobacter pylori(H. pylori) and Epstein-Barr virus(EBV), and genetic components.AIM To investigate microbiomes and host genome instability by cost-effective,low-coverage wholegenome sequencing,as biomarkers for GC subtyping.METHODS Samples from 40 GC patients were collected from Taizhou Hospital,Zhejiang Province,affiliated with Wenzhou Medical University.DNA from the samples was subjected to low-coverage wholegenome sequencing with a median genome coverage of 1.86×(range:1.03×to 3.17×) by Illumina×10,followed by copy number analyses using a customized bioinformatics workflow ultrasensitive chromosomal aneuploidy detector.RESULTS Of the 40 GC samples,20 (50%) were found to be enriched with microbiomes.EBV DNA was detected in 5 GC patients (12.5%).H.pylori DNA was found in 15 (37.5%) patients.The other 20(50%) patients were found to have relatively higher genomic instability.Copy number amplifications of the oncogenes,ERBB2 and KRAS,were found in 9 (22.5%) and 7 (17.5%) of the GC samples,respectively.EBV enrichment was found to be associated with tumors in the gastric cardia and fundus.H.pylori enrichment was found to be associated with tumors in the pylorus and antrum.Tumors with elevated genomic instability showed no localization and could be observed in any location.Additionally,H.pylori-enriched GC was found to be associated with the Borrmann type Ⅱ/Ⅲ and gastritis history.EBV-enriched GC was not associated with gastritis.No statistically significant correlation was observed between genomic instability and gastritis.Furthermore,these three different molecular subtypes showed distinct survival outcomes (P=0.019).EBV-positive tumors had the best prognosis,whereas patients with high genomic instability (CIN+) showed the worst survival.Patients with H.pylori infection showed intermediate prognosis compared with the other two subtypes.CONCLUSION Thus,using low-coverage whole-genome sequencing,GC can be classified into three categories based on disease etiology;this classification may prove useful for GC diagnosis and precision medicine.

Effectiveness and safety of endoscopic resection for duodenal gastrointestinal stromal tumors:A single center analysis

BACKGROUND Endoscopic resection for duodenal gastrointestinal stromal tumors(GISTs)is still considered a great challenge with a high risk of complications,including perforation,bleeding,tumor rupture,and residual tumor.AIM To assess the effectiveness and safety of endoscopic resection for duodenal GISTs.METHODS Between January 2010 and January 2022,11 patients with duodenal GISTs were treated with endoscopic resection.Data were extracted for the incidence of complete resection,bleeding,perforation,postoperative infection,recurrence,and distant metastasis.RESULTS The incidence of successful complete resection of duodenal GISTs was 100%.Three cases(27.3%)had suspected positive margins,and the other 8 cases(72.7%)had negative vertical and horizontal margins.Perforation occurred in all 11 patients.The success rate of perforation closure was 100%,while 1 patient(9.1%)had suspected delayed perforation.All bleeding during the procedure was managed by endoscopic methods.One case(9.1%)had delayed bleeding.Postoperative infection occurred in 6 patients(54.5%),including 1 who developed septic shock and 1 who developed a right iliac fossa abscess.All 11 patients recovered and were discharged.The mean hospital stay was 15.3 d.During the follow-up period(14-80 mo),duodenal stenosis occurred in 1 case(9.1%),and no local recurrence or distant metastasis were detected.CONCLUSION Endoscopic resection for duodenal GISTs appears to be an effective and safe minimally invasive treatment when performed by an experienced endoscopist.

Study on the Mechanism of Shimian Granules (SMG) against Depression via Regulating Circadian Rhythms

Background:According to the World Health Organization,about 350 million people worldwide are suffering from depression.It's reported that depression has been linked to several circadian rhythm perturbations,suggesting a disruption of the circadian clock system in affective disorders.The present study investigates the possible molecular mechanism of Shimian granules(SMG)in treating depression via restoring disrupted circadian rhythms.Method:Firstly,network pharmacology approach was used to identify the compounds and potential targets of SMG in TCMIP and BATMAN-TCM database.Secondly,the differential expression genes were obtained by gene expression profiling in GEO database(GSE56931,GSE98793).Further,protein-protein interactions(PPI)network was used to screen out core targets by STRING v11.Moreover,functional enrichment was carried out in DAVID database.Conclusively,the"herbs-compounds-targets-pathways"network was established to explore the mechanism of SMG in the treatment of depression.Result:It was found out that 65 compounds,18 targets and three pathways contributed to SMG in treating depression by regulating disrupted circadian rhythms,which might relate to core targets TNF,IL10,VDR in cAMP and calcium signaling pathway.Conclusion:Network pharmacology combined with gene expression profiling exhibited a powerful means to investigate the possible mechanism of formula,which contributes to theoretical basis for further study of SMG in the treatment of depression.

Qualitative Analysis and Approximate Damped Oscillatory Solutions for a Kind of Nonlinear Dispersive-dissipative Equation

This paper makes qualitative analysis to the bounded traveling wave solutions for a kind of nonlinear dispersive-dissipative equation, and considers its solving problem. The relation is investigated between behavior of its solution and the dissipation coefficient. Further, all approximate damped oscillatory solutions when dissipation coefficient is small are presented by utilizing the method of undetermined coefficients according to the theory of rotated vector field in planar dynamical systems. Finally, error estimate is given by establishing the integral equation which reflects the relation between approximate and exact damped oscillatory solutions applying the idea of homogenization principle.

Exact Solitary-wave Solutions and Periodic Wave Solutions for Generalized Modified Boussinesq Equation and the Effect of Wave Velocity on Wave Shape

By means of the undetermined assumption method, we obtain some new exact solitary-wave solutions with hyperbolic secant function fractional form and periodic wave solutions with cosine function form for the generalized modified Boussinesq equation. We also discuss the boundedness of these solutions. More over, we study the correlative characteristic of the solitary-wave solutions and the periodic wave solutions along with the travelling wave velocity＇s variation.

Experimental research of the cavitation bubble dynamics during the second oscillation period near a spherical particle

In this paper,the dynamic behaviors of the cavitation bubble near a fixed spherical particle during the second oscillation period are analyzed based on the high-speed photographic system.The deformation and motion of the bubble during the second period are investigated by changing the distance between the particle and the bubble and the maximum radius of the bubble.Meanwhile,the variation of the equivalent radius and the centroid motions are analyzed,and the dynamic behaviors of the bubble are categorized according to the bubble morphological characteristics during the second period.Through this research,it is found that(1)The dynamic behaviors of the bubble during the second oscillation period could be divided into three typical cases:For case 1,a bulge would exist on the bubble interface away from the particle,and for case 2,a bulge would appear on the bubble interface and evolve towards the particle,while for case 3,the bubble would be divided into two parts.(2)The larger the dimensionless distance between the particle and the bubble,the smaller the maximum bubble equivalent radius in the second period,and the shorter the second oscillation period.(3)When the bubble is close to the particle,a counter-jet appears at the bubble interface away from the particle during the rebound stage.

量子计算机辅助设计先进的超导量子比特:Plasmonium

复杂的超导量子电路可以用来设计对噪声免疫的量子比特,但其复杂性可能会超出经典计算机所具备的模拟能力.在这种情况下,可以借助量子计算机来对其进行高效的模拟.在这项工作中,作者展示了在基于transmon比特的量子计算机上,利用变分量子算法模拟一种超导量子电路,并且基于此设计了一种新的量子比特“Plasmonium”,它工作在等离子体跃迁区域.文中展示的Plasmonium量子比特展示出了较高的两比特门保真度99.58(3)%.相比于transmon比特,它具有更小的物理尺寸和更大的非谐性.这些特征使得Plasmonium可以成为制造多比特量子处理器强有力的候选者.这项研究结果证实了利用量子计算机辅助设计更先进的量子处理器的可能性.

Concomitant atypical knee gout and seronegative rheumatoid arthritis:A case report

BACKGROUND Gout and seronegative rheumatoid arthritis(SNRA)are two distinct inflammatory joint diseases whose co-occurrence is relatively infrequently reported.Limited information is available regarding the clinical management and prognosis of these combined diseases.CASE SUMMARY A 57-year-old woman with a 20-year history of joint swelling,tenderness,and morning stiffness who was negative for rheumatoid factor and had a normal uric acid level was diagnosed with SNRA.The initial regimen of methotrexate,leflunomide,and celecoxib alleviated her symptoms,except for those associated with the knee.After symptom recurrence after medication cessation,her regimen was updated to include iguratimod,methotrexate,methylprednisolone,and folic acid,but her knee issues persisted.Minimally invasive needle-knife scope therapy revealed proliferating pannus and needle-shaped crystals in the knee,indicating coexistent SNRA and atypical knee gout.After postarthroscopic surgery to remove the synovium and urate crystals,and following a tailored regimen of methotrexate,leflunomide,celecoxib,benzbromarone,and allopurinol,her knee symptoms were significantly alleviated with no recurrence observed over a period of more than one year,indicating successful management of both conditions.CONCLUSION This study reports the case of a patient concurrently afflicted with atypical gout of the knee and SNRA and underscores the significance of minimally invasive joint techniques as effective diagnostic and therapeutic tools in the field of rheumatology and immunology.