Gibberellin(GA)is one of the major plant hormones that promote parthenocarpy,a highly valuable agronomic trait.Here,we demonstrated that exogenous GA3application triggered the formation of parthenocarpic fruits with s...Gibberellin(GA)is one of the major plant hormones that promote parthenocarpy,a highly valuable agronomic trait.Here,we demonstrated that exogenous GA3application triggered the formation of parthenocarpic fruits with smaller size but unchanged shape in tomato(Solanum lycopersicum).These fruits exhibited a thicker pericarp,undeveloped ovules,and few jelly tissues,leading to smaller locules with empty cavities.Histological investigation showed that GA treatment produced more cell layers with larger cells in the pericarp,suggesting its promotion in both cell division and expansion.Transcriptomic analyses between GA-3and mock-treated unpollinated ovaries/fruits identified a large number of differentially expressed genes related to hormones,cell division,cell expansion,and transcription factors,implying that they coordinately regulated parthenocarpy conferred by GA.In particular,the downregulation of five reported repressors of tomato parthenocarpy,including two auxin signaling components,AUXIN RESPONSE FACTOR5(SlARF5)and Sl ARF7,and three MADS-box genes,TOMATO APETALA3(TAP3),TOMATO PISTILLATA(TPI),and AGAMOUS-LIKE6(SlAGL6),after GA treatment might play a key role in this process.Furthermore,we found that the knockdown of a GA signaling factor SlMYB33,which was depressed by GA treatment,induced parthenocarpic fruit set in tomato,an effect that might have been achieved by enhancing GA biosynthesis and decreasing the expression of some repressors of tomato parthenocarpy.Thus,our results provide a basis for understanding the regulatory mechanism of GA in tomato parthenocarpy.展开更多
Ischemic stroke(IS)is a multifactorial and heterogeneous disease.Despite years of studies,effective strategies for the diagnosis,management and treatment of stroke are still lacking in clinical practice.Metabolomics i...Ischemic stroke(IS)is a multifactorial and heterogeneous disease.Despite years of studies,effective strategies for the diagnosis,management and treatment of stroke are still lacking in clinical practice.Metabolomics is a growing field in systems biology.It is starting to show promise in the identification of biomarkers and in the use of pharmacometabolomics to help patients with certain disorders choose their course of treatment.The development of metabolomics has enabled further and more biological applications.Particularly,metabolomics is increasingly being used to diagnose diseases,discover new drug targets,elucidate mechanisms,and monitor therapeutic outcomes and its potential effect on precision medicine.In this review,we reviewed some recent advances in the study of metabolomics as well as how metabolomics might be used to identify novel biomarkers and understand the mechanisms of IS.Then,the use of metabolomics approaches to investigate the molecular processes and active ingredients of Chinese herbal formulations with anti-IS capabilities is summarized.We finally summarized recent developments in single cell metabolomics for exploring the metabolic profiles of single cells.Although the field is relatively young,the development of single cell metabolomics promises to provide a powerful tool for unraveling the pathogenesis of IS.展开更多
Accurate prediction ofmonthly oil and gas production is essential for oil enterprises tomake reasonable production plans,avoid blind investment and realize sustainable development.Traditional oil well production trend...Accurate prediction ofmonthly oil and gas production is essential for oil enterprises tomake reasonable production plans,avoid blind investment and realize sustainable development.Traditional oil well production trend prediction methods are based on years of oil field production experience and expertise,and the application conditions are very demanding.With the rapid development of artificial intelligence technology,big data analysis methods are gradually applied in various sub-fields of the oil and gas reservoir development.Based on the data-driven artificial intelligence algorithmGradient BoostingDecision Tree(GBDT),this paper predicts the initial single-layer production by considering geological data,fluid PVT data and well data.The results show that the GBDT algorithm prediction model has great accuracy,significantly improving efficiency and strong universal applicability.The GBDTmethod trained in this paper can predict production,which is helpful for well site optimization,perforation layer optimization and engineering parameter optimization and has guiding significance for oilfield development.展开更多
This paper reports an improved time-delay estimation(TDE)technique for the derivation of turbulence structures based on gas-puff imaging data.The improved TDE technique,integrating an inverse timing search and hierarc...This paper reports an improved time-delay estimation(TDE)technique for the derivation of turbulence structures based on gas-puff imaging data.The improved TDE technique,integrating an inverse timing search and hierarchical strategy,offers superior accuracy in calculating turbulent velocity field maps and analyzing blob dynamics,which has the power to obtain the radial profiles of equilibrium poloidal velocity,blob size and its radial velocity,even the fluctuation analysis,such as geodesic acoustic modes and quasi-coherent mode,etc.This improved technique could provide important 2D information for the study of edge turbulence and blob dynamics,advancing the understanding of edge turbulence physics in fusion plasmas.展开更多
BACKGROUND The incidence and mortality rate of colorectal cancer progressively increase with age and become particularly prominent after the age of 50 years.Therefore,the population that is≥50 years in age requires l...BACKGROUND The incidence and mortality rate of colorectal cancer progressively increase with age and become particularly prominent after the age of 50 years.Therefore,the population that is≥50 years in age requires long-term and regular colonoscopies.Uncomfortable bowel preparation is the main reason preventing patients from undergoing regular colonoscopies.The standard bowel preparation regimen of 4-L polyethylene glycol(PEG)is effective but poorly tolerated.AIM To investigate an effective and comfortable bowel preparation regimen for hospitalized patients≥50 years in age.METHODS Patients were randomly assigned to group 1(2-L PEG+30-mL lactulose+a lowresidue diet)or group 2(4-L PEG).Adequate bowel preparation was defined as a Boston bowel preparation scale(BBPS)score of≥6,with a score of≥2 for each segment.Non-inferiority was prespecified with a margin of 10%.Additionally,the degree of comfort was assessed based on the comfort questionnaire.RESULTS The proportion of patients with a BBPS score of≥6 in group 1 was not significantly different from that in group 2,as demonstrated by intention-to-treat(91.2%vs 91.0%,P=0.953)and per-protocol(91.8%vs 91.0%,P=0.802)analyses.Furthermore,in patients≥75 years in age,the proportion of BBPS scores of≥6 in group 1 was not significantly different from that in group 2(90.9%vs 97.0%,P=0.716).Group 1 had higher comfort scores(8.85±1.162 vs 7.59±1.735,P<0.001),longer sleep duration(6.86±1.204 h vs 5.80±1.730 h,P<0.001),and fewer awakenings(1.42±1.183 vs 2.04±1.835,P=0.026)than group 2.CONCLUSION For hospitalized patients≥50 years in age,the bowel preparation regimen comprising 2-L PEG+30-mL lactulose+a low-residue diet produced a cleanse that was as effective as the 4-L PEG regimen and even provided better comfort.展开更多
AIM:To investigate the changes in the expression of micro RNA-181a(mi R-181a)and Bim in a rat model of retinal ischemia-reperfusion(RIR),to explore their target relationship in RIR and their involvement in regula...AIM:To investigate the changes in the expression of micro RNA-181a(mi R-181a)and Bim in a rat model of retinal ischemia-reperfusion(RIR),to explore their target relationship in RIR and their involvement in regulating apoptosis of retinal ganglion cells(RGCs).·M ETHODS:Target gene prediction for mi R-181a was performed with the aid of bioinformatics and Bim was identified as a potential target gene of mi R-181a.A rat model of RIR was created by increasing the intraocular pressure.RGCs in the flatmounted retinas were labeled with Brn3,a marker for alive RGCs,by immunofluorescent staining.The changes in the number of RGCs after RIR were recorded.Quantitative reverse transcription-polymerase chain reaction(q RT-PCR)was used to determine the expression level of mi R-181a in the retina.Bim/Brn3 double immunofluorescence was used to detect the localization of Bim.The expression of Bim in the retina was determined with the aids of Western blot and q RT-PCR.·R ESULTS:Compared with the negative control group,the density of RGCs was significantly lower in the ischemia/reperfusion(I/R)-24h and I/R-72h groups(〈0.001).The expression level of mi R-181a started to decrease at 0h after RIR,and further decreased at 24h and 72h compared with the negative control group(〈0.001).Bim was significantly upregulated at 12h after RIR(〈0.05)and reached peak at 24,72h compared with the negative control group(〈0.01).Pearson correlation analysis showed that the expression level of Bim was negatively correlated with the expression level of mi R-181a and the density of RGCs.·CONCLUSION:Bim may be a potential target gene of mi R-181a.Both mi R-181a and Bim are involved in RGCs death in RIR.RIR may promote RGCs apoptosis in the retina downregulation of mi R-181a and its inhibition on Bim expression.展开更多
Background context:Metastatic spinal cord compression(MSCC)seriously affects the survival rate.Objective:The therapeutic effects of two treatment strategies for MSCC:percutaneous vertebroplasty(PVP)combined with radio...Background context:Metastatic spinal cord compression(MSCC)seriously affects the survival rate.Objective:The therapeutic effects of two treatment strategies for MSCC:percutaneous vertebroplasty(PVP)combined with radiofrequency ablation(RFA)and PVP combined with^(125)I particle implantation,were compared.Study design:Retrospective study.Patient sample:40 patients with MSCC were divided into two groups:19 cases in the RFA group and 21 cases in the^(125)I group.Method:All patients were accessed to determine the differences in pain,which was evaluated using the visual analog scale(VAS)at 1 week,1 month,and 3 months after the operation,and spinal stenosis rates(SSRs),which were measured at 1 and 3 months after the operation,between the two groups.Results:The VAS scores and SSRs at baseline were comparable between the RFA group and the^(125)I group(7.19±2.07 vs 7.42±1.95,37.7%±11.2%vs 41.1%±11.4%).The VAS scores and SSRs at 1 month and 3 months after the operation were significantly reduced in both groups,compared with those at baseline.The VAS scores and SSRs in the^(125)I group were lower than those in the RFA group at 3 months after the operation(1.09±0.97 vs 1.75±1.06 p=0.048 and 12.3%±6.4%vs 18.1%±10.1%p=0.034),while the VAS scores at1 week after the operation in the RFA group were lower than those in the^(125)I group(4.39±1.34 vs 5.05±1.82 p=0.049).Conclusion:PVP combined with RFA has a slight advantage in relieving pain in the short term,while PVP combined with^(125)I particle implantation may have a better effect in the relieving pain and decreasing the SSRs at 3 months after the operation.展开更多
Background:Until January 18,2021,coronavirus disease-2019(COVID-19)has infected more than 93 million individuals and has caused a certain degree of panic.Viral pneumonia caused by common viruses such as respiratory sy...Background:Until January 18,2021,coronavirus disease-2019(COVID-19)has infected more than 93 million individuals and has caused a certain degree of panic.Viral pneumonia caused by common viruses such as respiratory syncytial virus,rhinovirus,human metapneumovirus,human bocavirus,and parainfluenza viruses have been more common in children.However,the incidence of COVID-19 in children was significantly lower than that in adults.The purpose of this study was to describe the clinical manifestations,treatment and outcomes of COVID-19 in children compared with those of other sources of viral pneumonia diagnosed during the COVID-19 outbreak.Methods:Children with COVID-19 and viral pneumonia admitted to 20 hospitals were enrolled in this retrospective multi-center cohort study.A total of 64 children with COVID-19 were defined as the COVID-19 cohort,of which 40 children who developed pneumonia were defined as the COVID-19 pneumonia cohort.Another 284 children with pneumonia caused by other viruses were defined as the viral pneumonia cohort.The epidemiologic,clinical,and laboratory findings were compared by Kolmogorov-Smirnov test,t-test,Mann-Whitney U test and Contingency table method.Drug usage,immunotherapy,blood transfusion,and need for oxygen support were collected as the treatment indexes.Mortality,intensive care needs and symptomatic duration were collected as the outcome indicators.Results:Compared with the viral pneumonia cohort,children in the COVID-19 cohort were mostly exposed to family members confirmed to have COVID-19(53/64 vs.23/284),were of older median age(6.3 years vs.3.2 years),and had a higher proportion of ground-glass opacity(GGO)on computed tomography(18/40 vs.0/38,P<0.001).Children in the COVID-19 pneumonia cohort had a lower proportion of severe cases(1/40 vs.38/284,P=0.048),and lower cases with high fever(3/40 vs.167/284,P<0.001),requiring intensive care(1/40 vs.32/284,P<0.047)and with shorter symptomatic duration(median 5d vs.8d,P<0.001).The proportion of cases with evaluated inflammatory indicators,biochemical indicators related to organ or tissue damage,D-dimer and secondary bacterial infection were lower in the COVID-19 pneumonia cohort than those in the viral pneumonia cohort(P<0.05).No statistical differences were found in the duration of positive PCR results from pharyngeal swabs in 25 children with COVID-19 who received antiviral drugs(lopinavir-ritonavir,ribavirin,and arbidol)as compared with duration in 39 children without antiviral therapy(median 10d vs.9d,P=0.885).Conclusions:The symptoms and severity of COVID-19 pneumonia in children were no more severe than those in children with other viral pneumonia.Lopinavir-ritonavir,ribavirin and arbidol do not shorten the duration of positive PCR results from pharyngeal swabs in children with COVID-19.During the COVID-19 outbreak,attention also must be given to children with infection by other pathogens infection.展开更多
Kaposiform hemangioendothelioma (KHE) is a rare locally ag- gressive vascular tumor that mainly occurs in children and early adolescents. It is often associated with the
BACKGROUND Hilar cholangiocarcinoma is the most common malignant tumor of the extrahepatic bile duct.Until now,radical resection has been the most effective method for the long-term survival of patients with the disea...BACKGROUND Hilar cholangiocarcinoma is the most common malignant tumor of the extrahepatic bile duct.Until now,radical resection has been the most effective method for the long-term survival of patients with the disease.However,many problems have emerged in the field of hepatobiliary surgery for a long time,including complex surgical procedures,low resection rate,and postoperative complications.We have adopted the“multiple Roux-en-Y hepaticojejunostomy reconstruction by formation of a bile duct lake”technique in the treatment of hilar cholangiocarcinoma since 2008,and obtained satisfactory short-and longterm results.AIM To examine the feasibility of the application of multiple Roux-en-Y hepaticojejunostomy reconstruction by formation of a bile duct lake in the operation of hilar cholangiocarcinoma METHODS A retrospective analysis was performed for the clinical data,surgical methods,and results of 76 patients with hilar cholangiocarcinoma who were treated with hilar bile duct lake-forming multiple Roux-en-Y hepaticojejunostomy reconstruction at Gansu Provincial Hospital.RESULTS In all 76 cases,the operation was successful and no operative death occurred.The mean(range)operation time was 215.4±53.5 min(124–678 min),and the amount of bleeding during the operation was 428.2±63.8 mL(240–2200 mL).The overall 1-year survival rate was 78.9%,and the 3-year survival rate was 32.8%.CONCLUSION The multiple Roux-en-Y hepaticojejunostomy reconstruction technique with formation of a bile duct lake is safe and effective for the surgical treatment of hilar cholangiocarcinoma.展开更多
基金supported by the Key Program of Natural Science Basic Research Plan in Shaanxi Province of China(Grant No.2021JZ-13)。
文摘Gibberellin(GA)is one of the major plant hormones that promote parthenocarpy,a highly valuable agronomic trait.Here,we demonstrated that exogenous GA3application triggered the formation of parthenocarpic fruits with smaller size but unchanged shape in tomato(Solanum lycopersicum).These fruits exhibited a thicker pericarp,undeveloped ovules,and few jelly tissues,leading to smaller locules with empty cavities.Histological investigation showed that GA treatment produced more cell layers with larger cells in the pericarp,suggesting its promotion in both cell division and expansion.Transcriptomic analyses between GA-3and mock-treated unpollinated ovaries/fruits identified a large number of differentially expressed genes related to hormones,cell division,cell expansion,and transcription factors,implying that they coordinately regulated parthenocarpy conferred by GA.In particular,the downregulation of five reported repressors of tomato parthenocarpy,including two auxin signaling components,AUXIN RESPONSE FACTOR5(SlARF5)and Sl ARF7,and three MADS-box genes,TOMATO APETALA3(TAP3),TOMATO PISTILLATA(TPI),and AGAMOUS-LIKE6(SlAGL6),after GA treatment might play a key role in this process.Furthermore,we found that the knockdown of a GA signaling factor SlMYB33,which was depressed by GA treatment,induced parthenocarpic fruit set in tomato,an effect that might have been achieved by enhancing GA biosynthesis and decreasing the expression of some repressors of tomato parthenocarpy.Thus,our results provide a basis for understanding the regulatory mechanism of GA in tomato parthenocarpy.
基金supported by the National Natural Science Foundation of China(Grant Nos.:81873226,and 81874366)the Zhejiang Provincial Science and Technology Innovation Leading Talent Project of“Ten Thousand Talents Plan”(2019).
文摘Ischemic stroke(IS)is a multifactorial and heterogeneous disease.Despite years of studies,effective strategies for the diagnosis,management and treatment of stroke are still lacking in clinical practice.Metabolomics is a growing field in systems biology.It is starting to show promise in the identification of biomarkers and in the use of pharmacometabolomics to help patients with certain disorders choose their course of treatment.The development of metabolomics has enabled further and more biological applications.Particularly,metabolomics is increasingly being used to diagnose diseases,discover new drug targets,elucidate mechanisms,and monitor therapeutic outcomes and its potential effect on precision medicine.In this review,we reviewed some recent advances in the study of metabolomics as well as how metabolomics might be used to identify novel biomarkers and understand the mechanisms of IS.Then,the use of metabolomics approaches to investigate the molecular processes and active ingredients of Chinese herbal formulations with anti-IS capabilities is summarized.We finally summarized recent developments in single cell metabolomics for exploring the metabolic profiles of single cells.Although the field is relatively young,the development of single cell metabolomics promises to provide a powerful tool for unraveling the pathogenesis of IS.
文摘Accurate prediction ofmonthly oil and gas production is essential for oil enterprises tomake reasonable production plans,avoid blind investment and realize sustainable development.Traditional oil well production trend prediction methods are based on years of oil field production experience and expertise,and the application conditions are very demanding.With the rapid development of artificial intelligence technology,big data analysis methods are gradually applied in various sub-fields of the oil and gas reservoir development.Based on the data-driven artificial intelligence algorithmGradient BoostingDecision Tree(GBDT),this paper predicts the initial single-layer production by considering geological data,fluid PVT data and well data.The results show that the GBDT algorithm prediction model has great accuracy,significantly improving efficiency and strong universal applicability.The GBDTmethod trained in this paper can predict production,which is helpful for well site optimization,perforation layer optimization and engineering parameter optimization and has guiding significance for oilfield development.
基金partially supported by the National Key R&D Program of China(Nos.2019YFE03030002 and 2022YFE03030001)National Natural Science Foundation of China(Nos.12175186 and 12175055)the Natural Science Foundation of Sichuan Province(Nos.2022NSFSC1820 and 2023NSFSC1289)。
文摘This paper reports an improved time-delay estimation(TDE)technique for the derivation of turbulence structures based on gas-puff imaging data.The improved TDE technique,integrating an inverse timing search and hierarchical strategy,offers superior accuracy in calculating turbulent velocity field maps and analyzing blob dynamics,which has the power to obtain the radial profiles of equilibrium poloidal velocity,blob size and its radial velocity,even the fluctuation analysis,such as geodesic acoustic modes and quasi-coherent mode,etc.This improved technique could provide important 2D information for the study of edge turbulence and blob dynamics,advancing the understanding of edge turbulence physics in fusion plasmas.
基金The study was approved by the Ethics Committee of Beijing Tongren Hospital Affiliated to Capital Medical University(Approval No.TRECKY2021-227).
文摘BACKGROUND The incidence and mortality rate of colorectal cancer progressively increase with age and become particularly prominent after the age of 50 years.Therefore,the population that is≥50 years in age requires long-term and regular colonoscopies.Uncomfortable bowel preparation is the main reason preventing patients from undergoing regular colonoscopies.The standard bowel preparation regimen of 4-L polyethylene glycol(PEG)is effective but poorly tolerated.AIM To investigate an effective and comfortable bowel preparation regimen for hospitalized patients≥50 years in age.METHODS Patients were randomly assigned to group 1(2-L PEG+30-mL lactulose+a lowresidue diet)or group 2(4-L PEG).Adequate bowel preparation was defined as a Boston bowel preparation scale(BBPS)score of≥6,with a score of≥2 for each segment.Non-inferiority was prespecified with a margin of 10%.Additionally,the degree of comfort was assessed based on the comfort questionnaire.RESULTS The proportion of patients with a BBPS score of≥6 in group 1 was not significantly different from that in group 2,as demonstrated by intention-to-treat(91.2%vs 91.0%,P=0.953)and per-protocol(91.8%vs 91.0%,P=0.802)analyses.Furthermore,in patients≥75 years in age,the proportion of BBPS scores of≥6 in group 1 was not significantly different from that in group 2(90.9%vs 97.0%,P=0.716).Group 1 had higher comfort scores(8.85±1.162 vs 7.59±1.735,P<0.001),longer sleep duration(6.86±1.204 h vs 5.80±1.730 h,P<0.001),and fewer awakenings(1.42±1.183 vs 2.04±1.835,P=0.026)than group 2.CONCLUSION For hospitalized patients≥50 years in age,the bowel preparation regimen comprising 2-L PEG+30-mL lactulose+a low-residue diet produced a cleanse that was as effective as the 4-L PEG regimen and even provided better comfort.
基金Supported by the National Natural Science Foundation of China(No.81070742/H1205)the International Collaboration Foundation from the Department of Science and Technology of Sichuan Province,China(No.2010HH0030)
文摘AIM:To investigate the changes in the expression of micro RNA-181a(mi R-181a)and Bim in a rat model of retinal ischemia-reperfusion(RIR),to explore their target relationship in RIR and their involvement in regulating apoptosis of retinal ganglion cells(RGCs).·M ETHODS:Target gene prediction for mi R-181a was performed with the aid of bioinformatics and Bim was identified as a potential target gene of mi R-181a.A rat model of RIR was created by increasing the intraocular pressure.RGCs in the flatmounted retinas were labeled with Brn3,a marker for alive RGCs,by immunofluorescent staining.The changes in the number of RGCs after RIR were recorded.Quantitative reverse transcription-polymerase chain reaction(q RT-PCR)was used to determine the expression level of mi R-181a in the retina.Bim/Brn3 double immunofluorescence was used to detect the localization of Bim.The expression of Bim in the retina was determined with the aids of Western blot and q RT-PCR.·R ESULTS:Compared with the negative control group,the density of RGCs was significantly lower in the ischemia/reperfusion(I/R)-24h and I/R-72h groups(〈0.001).The expression level of mi R-181a started to decrease at 0h after RIR,and further decreased at 24h and 72h compared with the negative control group(〈0.001).Bim was significantly upregulated at 12h after RIR(〈0.05)and reached peak at 24,72h compared with the negative control group(〈0.01).Pearson correlation analysis showed that the expression level of Bim was negatively correlated with the expression level of mi R-181a and the density of RGCs.·CONCLUSION:Bim may be a potential target gene of mi R-181a.Both mi R-181a and Bim are involved in RGCs death in RIR.RIR may promote RGCs apoptosis in the retina downregulation of mi R-181a and its inhibition on Bim expression.
文摘Background context:Metastatic spinal cord compression(MSCC)seriously affects the survival rate.Objective:The therapeutic effects of two treatment strategies for MSCC:percutaneous vertebroplasty(PVP)combined with radiofrequency ablation(RFA)and PVP combined with^(125)I particle implantation,were compared.Study design:Retrospective study.Patient sample:40 patients with MSCC were divided into two groups:19 cases in the RFA group and 21 cases in the^(125)I group.Method:All patients were accessed to determine the differences in pain,which was evaluated using the visual analog scale(VAS)at 1 week,1 month,and 3 months after the operation,and spinal stenosis rates(SSRs),which were measured at 1 and 3 months after the operation,between the two groups.Results:The VAS scores and SSRs at baseline were comparable between the RFA group and the^(125)I group(7.19±2.07 vs 7.42±1.95,37.7%±11.2%vs 41.1%±11.4%).The VAS scores and SSRs at 1 month and 3 months after the operation were significantly reduced in both groups,compared with those at baseline.The VAS scores and SSRs in the^(125)I group were lower than those in the RFA group at 3 months after the operation(1.09±0.97 vs 1.75±1.06 p=0.048 and 12.3%±6.4%vs 18.1%±10.1%p=0.034),while the VAS scores at1 week after the operation in the RFA group were lower than those in the^(125)I group(4.39±1.34 vs 5.05±1.82 p=0.049).Conclusion:PVP combined with RFA has a slight advantage in relieving pain in the short term,while PVP combined with^(125)I particle implantation may have a better effect in the relieving pain and decreasing the SSRs at 3 months after the operation.
基金Scientific Research Project of Military Logistics Department,Grant Award Number:CLB20J032。
文摘Background:Until January 18,2021,coronavirus disease-2019(COVID-19)has infected more than 93 million individuals and has caused a certain degree of panic.Viral pneumonia caused by common viruses such as respiratory syncytial virus,rhinovirus,human metapneumovirus,human bocavirus,and parainfluenza viruses have been more common in children.However,the incidence of COVID-19 in children was significantly lower than that in adults.The purpose of this study was to describe the clinical manifestations,treatment and outcomes of COVID-19 in children compared with those of other sources of viral pneumonia diagnosed during the COVID-19 outbreak.Methods:Children with COVID-19 and viral pneumonia admitted to 20 hospitals were enrolled in this retrospective multi-center cohort study.A total of 64 children with COVID-19 were defined as the COVID-19 cohort,of which 40 children who developed pneumonia were defined as the COVID-19 pneumonia cohort.Another 284 children with pneumonia caused by other viruses were defined as the viral pneumonia cohort.The epidemiologic,clinical,and laboratory findings were compared by Kolmogorov-Smirnov test,t-test,Mann-Whitney U test and Contingency table method.Drug usage,immunotherapy,blood transfusion,and need for oxygen support were collected as the treatment indexes.Mortality,intensive care needs and symptomatic duration were collected as the outcome indicators.Results:Compared with the viral pneumonia cohort,children in the COVID-19 cohort were mostly exposed to family members confirmed to have COVID-19(53/64 vs.23/284),were of older median age(6.3 years vs.3.2 years),and had a higher proportion of ground-glass opacity(GGO)on computed tomography(18/40 vs.0/38,P<0.001).Children in the COVID-19 pneumonia cohort had a lower proportion of severe cases(1/40 vs.38/284,P=0.048),and lower cases with high fever(3/40 vs.167/284,P<0.001),requiring intensive care(1/40 vs.32/284,P<0.047)and with shorter symptomatic duration(median 5d vs.8d,P<0.001).The proportion of cases with evaluated inflammatory indicators,biochemical indicators related to organ or tissue damage,D-dimer and secondary bacterial infection were lower in the COVID-19 pneumonia cohort than those in the viral pneumonia cohort(P<0.05).No statistical differences were found in the duration of positive PCR results from pharyngeal swabs in 25 children with COVID-19 who received antiviral drugs(lopinavir-ritonavir,ribavirin,and arbidol)as compared with duration in 39 children without antiviral therapy(median 10d vs.9d,P=0.885).Conclusions:The symptoms and severity of COVID-19 pneumonia in children were no more severe than those in children with other viral pneumonia.Lopinavir-ritonavir,ribavirin and arbidol do not shorten the duration of positive PCR results from pharyngeal swabs in children with COVID-19.During the COVID-19 outbreak,attention also must be given to children with infection by other pathogens infection.
文摘Kaposiform hemangioendothelioma (KHE) is a rare locally ag- gressive vascular tumor that mainly occurs in children and early adolescents. It is often associated with the
基金Supported by National Natural Science Foundation of China,No.81260326 and No.81660398Natural Science Foundation of Gansu Province,No.17JR5RA034
文摘BACKGROUND Hilar cholangiocarcinoma is the most common malignant tumor of the extrahepatic bile duct.Until now,radical resection has been the most effective method for the long-term survival of patients with the disease.However,many problems have emerged in the field of hepatobiliary surgery for a long time,including complex surgical procedures,low resection rate,and postoperative complications.We have adopted the“multiple Roux-en-Y hepaticojejunostomy reconstruction by formation of a bile duct lake”technique in the treatment of hilar cholangiocarcinoma since 2008,and obtained satisfactory short-and longterm results.AIM To examine the feasibility of the application of multiple Roux-en-Y hepaticojejunostomy reconstruction by formation of a bile duct lake in the operation of hilar cholangiocarcinoma METHODS A retrospective analysis was performed for the clinical data,surgical methods,and results of 76 patients with hilar cholangiocarcinoma who were treated with hilar bile duct lake-forming multiple Roux-en-Y hepaticojejunostomy reconstruction at Gansu Provincial Hospital.RESULTS In all 76 cases,the operation was successful and no operative death occurred.The mean(range)operation time was 215.4±53.5 min(124–678 min),and the amount of bleeding during the operation was 428.2±63.8 mL(240–2200 mL).The overall 1-year survival rate was 78.9%,and the 3-year survival rate was 32.8%.CONCLUSION The multiple Roux-en-Y hepaticojejunostomy reconstruction technique with formation of a bile duct lake is safe and effective for the surgical treatment of hilar cholangiocarcinoma.