Low-grade fever during COVID-19 convalescence:A report of 3 cases

BACKGROUND Low-grade fever during convalescence is an atypical symptom of coronavirus disease 2019(COVID-19).Reports of such cases are rare,and the mechanism and outcome of low-grade fever during COVID-19 convalescence are not completely clear.We report 3 cases with low-grade fever during COVID-19 convalescence and highlight the main clinical,radiographic,and laboratory characteristics,thereby increasing the level of expertise in the clinical management of COVID-19 during convalescence and facilitating individualized decision-making.CASE SUMMARY We describe 3 patients with COVID-19,two females aged 62 and 66 years and a male 55 years,who had low-grade fever during COVID-19 convalescence.All 3 patients had no other discomfort or comorbidities during low-grade process.Lesions on computed tomography in all 3 patients had resolved during this period.Two patients tested negative on two consecutive severe acute respiratory syndrome coronavirus 2 tests with an interval of at least 24 h between tests.Body temperature in all 3 patients returned to normal after several days without treatment,and fever recurrence was not observed.CONCLUSION Enhancing the knowledge of low-grade fever during COVID-19 convalescence may increase the expertise in the delivery of optimal healthcare services.

A new approach for recycling arsenic and tin from low-grade tin middlings using a self-sulfurization roasting

Massive amounts of low-grade tin middlings have been produced from tin tailings,in which arsenic and tin are worthy to be recycled.Owing to high sulfur content in these tin middlings,a novel self-sulfurization roasting was proposed to transform,separate and recover arsenic and tin in this research.There was no extra curing agent to be added,which decreased the formation of pollutant S-containing gas.The self-sulfurization process involved a two-stage roasting of reduction followed by sulfurization.First in reduction roasting,FeAsS decomposed to FeS and As and the As then transformed to As_(4)(g)and As_(4)S_(4)(g),via which the arsenic was separated and recovered.The arsenic content in the first residue could be decreased to 0.72 wt.%.Accompanied with it,the FeS was firstly oxidized to Fe_(1−x)S and then to SO_(2)(g)by the coexisted Fe_(2)O_(3),and finally reduced and combined with the independent Fe_(2)O_(3)to form Fe_(1−x)S.In the followed sulfurization roasting,the Fe_(1−x)S sulfurized SnO_(2)to SnS(g),due to which tin could be recovered and its content in the second residue decreased to 0.01 wt.%.This study provided an efficient method to separate and recover arsenic and tin from low-grade tin middlings.

Asymptomatic low-grade appendiceal mucinous neoplasm:A case report

BACKGROUND Low-grade appendiceal neoplasms(LAMN)are characterized by low incidence and atypical clinical presentations,often leading to misdiagnosis as acute or chronic appendicitis before surgery.The primary diagnostic tool for LAMN is abdominal computed tomography(CT)imaging.Surgical resection remains the cornerstone of LAMN management,necessitating en bloc tumor excision to minimize the risk of iatrogenic rupture.Laparoscopy,known for its minimal invasiveness,reduced postoperative discomfort,and expedited recovery,is a safe and reliable approach for LAMN treatment.Despite the possibility of pseudomyxoma peritonei development,appendectomy and partial appendectomy generally result in negative tumor margins and favorable outcomes,which can be attributed to the disease’s slow growth and lower malignancy.CASE SUMMARY A 71-year-old male patient was admitted to our hospital with a pelvic spaceoccupying lesion detected 1 mo prior.Physical examination showed a soft abdomen without tenderness or rebound and no palpable masses.No shifting dullness was noted,and digital rectal examination revealed no palpable mass.Enteroscopy revealed a raised,smooth-surfaced mass measuring 3.0 cm in the cecum.Abdominal contrast-enhanced CT showed a markedly thickened and dilated appendix with visible cystic shadows.Laparoscopic surgery was performed and revealed a significantly dilated appendix,leading to laparoscopic resection of the appendix and part of the cecum.Post-surgical pathologic analysis confirmed LAMN.The patient received symptomatic and supportive post-operative care and was discharged on postoperative day 4 without complications such as abdominal bleeding,intestinal obstruction,or incision infection.No tumor recurrence was observed during a 7-mo follow-up period.CONCLUSION LAMN is a rare disease that lacks specific clinical manifestations.Abdominal CT plays a crucial role in diagnosing LAMN,and laparoscopic surgery is a safe and effective diagnostic and therapeutic approach.

Low-grade myofibrosarcoma of the maxillary sinus:Two case reports

BACKGROUND Low-grade myofibroblastic sarcoma(LGMS)is an extremely rare tumor characterized by the malignant proliferation of myofibroblasts.LGMS most commonly develops in adults,predominantly in males,in the head and neck region,oral cavity,especially on the tongue,mandible,and larynx.This article presents 2 cases of LGMS localized to the maxillary sinus and provides an overview of the available literature.CASE SUMMARY Two patients with LGMS located in the maxillary sinus underwent surgery at the Department of Head and Neck Surgery.Case 1:A 46-year-old patient was admitted to the clinic with suspected LGMS recurrence in the right maxillary sinus(rT4aN0M0),with symptoms of pain in the suborbital area,watering of the right eye,thick discharge from the right nostril,and augmented facial asymmetry.After open biopsy-confirmed LGMS,the patient underwent expanded maxillectomy of the right side with immediate palate reconstruction using a microvascular skin flap harvested surgically from the middle arm.The patient qualified for adjuvant radiotherapy for the postoperative bed,with an additional margin.Currently,the patient is under 1.5 years of observation with no evidence of disease.Case 2:A 45-year-old man was admitted to our clinic with facial asymmetry,strabismus,exophthalmos,and visual impairment in the right eye.Six months earlier,the patient had undergone partial jaw resection at another hospital for fibromatosis.A contrast-enhanced computed tomography scan revealed a tumor mass in the postoperative log after an earlier procedure.An open biopsy confirmed lowgrade fibrosarcoma(rT4aN0M0).The patient qualified for an extended total right maxillectomy with orbital excision and right hemimandibulectomy with immediate microvascular reconstruction using an anterolateral thigh flap.The patient subsequently underwent adjuvant radiotherapy to the postoperative area.After 9 months,recurrence occurred in the right mandibular arch below the irradiated area.The lesion infiltrated the base of the skull,which warranted the withdrawal of radiotherapy and salvage surgery.The patient qualified for palliative chemotherapy with a regimen of doxorubicin+dacarbazine+cyclophosphamide and palliative radiotherapy for bone metastases.The patient died 26 months after surgical treatment.The cases have been assessed and compared with cases in the literature.CONCLUSION No specific diagnostic criteria or treatment strategies have been developed for LGMS.The treatment used for LGMS is the same as that used for sinonasal cancer radical tumor excision;adjuvant radiotherapy or chemoradiotherapy should also be considered.They have low malignant potential but are highly invasive,tend to recur,and metastasize to distant sites.Patients should undergo regular follow-up examinations to detect recurrence or metastasis at an early stage.Patients should be treated and observed at the highest referral centers.

Application of NSR-AISC Method in Reserve Estimation and Technical Economic Evaluation of Low-Grade Polymetallic Deposits: Taking a Low-Grade Copper-Molybdenum Mine in Guangdong Province as an Example

The development and utilization of low-grade polymetallic deposits with strategic mineral resources is one of the important measures to alleviate the current high dependence on strategic mineral resources in China. However, domestic mining enterprises and most mining consulting and design institutes usually use general industrial indicators to carry out reserve estimation and technical and economic feasibility studies on low-grade polymetallic deposits, which cannot truly reflect the economic value of such deposits. The article expounds on the definitions of net return value (NSR) and on-site total maintenance cost (AISC) of common ore smelters in the evaluation of overseas mineral resources. Taking a low-grade polymetallic copper-molybdenum mine in Guangdong Province as an example, comparing the research results showed the NSR-AISC method and the general industrial index method in low-grade polymetallic deposit. There are huge differences in the results of reserve estimation;through the further introduction of Taylor’s formula and the research results on the relationship between investment intensity and production scale, a more reasonable mine life and investment scale are recommended, and a more in-depth comparative study has been carried out in the dimension of technical and economic indicators. Based on the comparative study of the above two methods in reserve estimation and the evaluation results of technical and economic indicators, the author believes that the NSR-AISC method can better reflect the true value of low-grade polymetallic ore projects, and should be popularized and applied in resource evaluation and development practice. This article further describes the application status of the NSR-AISC method for reserve estimation and the evaluation of technical economic indicators, and suggests the main points that should be paid attention to in the use of the NSR-AISC method.

Crimean-Congo hemorrhagic fever:Pathogenesis,transmission and public health challenges

The dangerous Crimean-Congo hemorrhagic fever virus(CCHFV),an encapsulated negative-sense RNA virus of the family Nairoviridae,is transmitted from person to person via ticks.With a case fatality rate between 10%to 40%,the most common ways that the disease may spread to humans are via tick bites or coming into touch with infected animals'blood or tissues.Furthermore,the transfer of bodily fluids between individuals is another potential route of infection.There is a wide range of symptoms experienced by patients throughout each stage,from myalgia and fever to extreme bruising and excess bleeding.Tick management measures include minimising the spread of ticks from one species to another and from people to animals via the use of protective clothing,repellents,and proper animal handling.In order to prevent the spread of illness,healthcare workers must adhere to stringent protocols.Despite the lack of an authorised vaccine,the main components of treatment now consist of preventative measures and supportive care,which may include the antiviral medicine ribavirin.We still don't know very much about the virus's mechanisms,even though advances in molecular virology and animal models have improved our understanding of the pathogenesis of CCHFV.A critical need for vaccination that is both safe and effective,as well as for quick diagnosis and efficient treatments to lessen the disease's impact in areas where it is most prevalent.Important steps towards lowering Crimean-Congo hemorrhagic fever mortality and morbidity rates were to anticipatethe future availability of immunoglobulin products.

King's College criteria and the Clichy-Villejuif criteria require adjustments for assessing acute liver failure due to yellow fever

BACKGROUND Acute liver failure(ALF)is a severe condition characterized by rapid deterioration of liver function in individuals without preexisting liver disease.Liver transplantation(LT)is the most impactful treatment.Yellow fever(YF)is an infectious disease that primarily affects the liver and has a high mortality rate.However,LT can be a viable option for treating rare cases with extensive liver involvement.However,the criteria for assessing the severity of ALF and determining the indications for transplantation have not been specifically validated for cases caused by YF.AIM To present necessary adjustments to established scoring systems for ALF secondary to YF.METHODS This was an observational,retrospective,single-center study.Fourteen consecutive patients with confirmed ALF due to YF were monitored in the intensive care unit by a specialized liver transplant team during a three-month epidemic outbreak in Brazil.During hospitalization,general supportive therapeutic measures were implemented,and the patients were regularly assessed using the King's College criteria and the Clichy-Villejuif criteria to determine the severity of liver failure.LT is considered a viable measure for patients with signs of end-stage liver failure.RESULTS Eight of 14(57%)patients developed severe neurological alterations within the first 96 hours after hospital admission.Four patients underwent emergency LT,and despite a moderate viral infection of the graft after transplantation,the 5-year survival rate was 50%.Although the King's College criteria and the Clichy-Villejuif criteria are the main scoring systems for ALF,they are insufficient for predicting the risk of mortality in this context,primarily because of low serum bilirubin levels in the final stage of the disease and significant disparities between coagulation abnormalities and patient severity.CONCLUSION To ensure good applicability in cases of YF-induced ALF,the authors suggest adaptations to the King's College and Clichy-Villejuif criteria.

Eosinophilia and clonorchiasis presenting as fever of unknown origin in adult patients

Fever of unknown origin (FUO) is recognized as fever with uncertain diagnosis despite three days of hospital admission or three or more outpatient visits.[1] Acute liver fluke infection is characterized by fever, right upper quadrant pain, hepatomegaly, jaundice, and peripheral bloodeosinophilia.Bycontrast,chronicliverfluke infection is asymptomatic in its early stage, but can easily progress to cirrhosis, cancer, or bile duct cancer initslaterstages. Thediagnosisofclonorchiasisis particularly challenging in non-endemic areas. We herein report an unusual case of liver fl uke infection in a patient who presented with FUO and eosinophilia.A 38-year-old male was admitted to our hospital with a history of intermittent and recurrent fever for over 10 d and a history of sudden abdominal pain for1 h. He had no other medical history. More than 10d ago, he visited our emergency department because of FUO, with his body temperature reaching 39.7°C,and he had no other symptoms at that time. Laboratory and radiological examinations revealed:white blood cell(WBC) counts, 10.9×109/L;neutrophil percentage, 84.5%;eosinophil percentage, 3.1%;C-reactive protein (CRP),141 mg/L;liver and kidney function, normal;influenza virus, negative;urine and stool tests, normal;and chest computed tomography (CT) fi ndings, normal. The fever subsided after 1 week of anti-infective treatment with moxifloxacin. Subsequent tests revealed the following results:WBC, 15.0×109/L;neutrophil percentage, 70.0%;eosinophil percentage, 16.8%;and CRP, 122 mg/L. The antimicrobial treatment was then discontinued.

Single-cell sequencing reveals the features of adaptive immune responses in the liver of a mouse model of dengue fever

Background:Dengue fever,an acute insect-borne infectious disease caused by the dengue virus(DENV),poses a great challenge to global public health.Hepatic involve-ment is the most common complication of severe dengue and is closely related to the occurrence and development of disease.However,the features of adaptive immune responses associated with liver injury in severe dengue are not clear.Methods:We used single-cell sequencing to examine the liver tissues of mild or se-vere dengue mice model to analyze the changes in immune response of T cells in the liver after dengue virus infection,and the immune interaction between macrophages and T cells.Flow cytometry was used to detect T cells and macrophages in mouse liver and blood to verify the single-cell sequencing results.Results:Our result showed CTLs were significantly activated in the severe liver injury group but the immune function-related signal pathway was down-regulated.The rea-son may be that the excessive immune response in the severe group at the late stage of DENV infection induces the polarization of macrophages into M2 type,and the macrophages then inhibit T cell immunity through the TGF-βsignaling pathway.In ad-dition,the increased proportion of Treg cells suggested that Th17/Treg homeostasis was disrupted in the livers of severe liver injury mice.Conclusions:In this study,single-cell sequencing and flow cytometry revealed the characteristic changes of T cell immune response and the role of macrophages in the liver of severe dengue fever mice.Our study provides a better understanding of the pathogenesis of liver injury in dengue fever patients.

Oxidation process of low-grade vanadium slag in presence of Na_(2)CO_3

The oxidation process of low-grade vanadium slag in the presence of Na2CO3 was investigated by XRD,SEM/EDS and TG-DSC techniques.The results show that the vanadium slag is oxidized in a temperature range from 273 to 700 °C.Olivine phases and spinel phases are completely decomposed at 500 and 600 °C,respectively.Most of water-soluble sodium vanadates are formed between 500 and 600 °C.When roasting temperature reaches above 700 °C,the vanadium-rich phases of sodium vanadates can be obviously observed.However,at temperature above 800 °C,the samples are sintered.Most of the vanadium is enwrapped by glassy phase compounds which lead to the decrease of the leaching rate of vanadium.At the same time,the effect of roasting temperature on extraction of vanadium and characterization of leach residues were discussed.

Leaching kinetics of low-grade copper ore containing calcium-magnesium carbonate in ammonia-ammonium sulfate solution with persulfate

The leaching kinetics of copper from low-grade copper ore was investigated in ammonia-ammonium sulfate solution with sodium persulfate. The effect parameters of stirring speed, temperature, particle size, concentrations of ammonia, ammonium sulfate and sodium persulfate were determined. The results show that the leaching rate is nearly independent of agitation above 300 r/min and increases with the increase of temperature, concentrations of ammonia, ammonium sulfate and sodium persulfate. The EDS analysis and phase quantitative analysis of the residues indicate that bornite can be dissolved by persulfate oxidization. The leaching kinetics with activation energy of 22.91 kJ/mol was analyzed by using a new shrinking core model （SCM） in which both the interfacial transfer and diffusion across the product layer affect the leaching rate. A semi-empirical rate equation was obtained to describe the leaching process and the empirical reaction orders with respect to the concentrations of ammonia, ammonium sulfate and sodium persulfate are 0.5, 1.2 and 0.5, respectively.

Review on development of low-grade scheelite recovery from molybdenum tailings in Luanchuan, China: A case study of Luoyang Yulu Mining Company

Luanchuan area is one of the regions with the largest scale of scheelite beneficiation and the largest output of scheelite concentrate in the world. After years of innovation and progress, the beneficiation technology of low-grade scheelite associated with molybdenum tailings in Luanchuan area is becoming more and more perfect. In this study, the development process of low-grade scheelite recycling technology in Luanchuan area was reviewed, including raw ore properties, beneficiation process, flotation equipment and flotation reagents. Meanwhile, taking Luoyang Yulu Mining Co., Ltd. as an example, the effects of various technical transformations such as the optimization of the beneficiation process, the column-machine combined process, and the high-efficiency flotation reagents were elucidated in detail. However, the recycling technology of low-grade scheelite of Luanchuan area is still possible to be improved. As a result, coupled with the latest research progress, the development direction of low-grade scheelite beneficiation in Luanchuan area was also prospected. It is of great significance to further improve the recovery efficiency of low-grade scheelite resources in Luanchuan area and this can provide technical reference for other scheelite plants.

Hepatic steatosis,low-grade chronic inflammation and hormone/growth factor/adipokine imbalance

Non-alcoholic fatty liver disease (NAFLD), a further expression of metabolic syndrome, strictly linked to obesity and diabetes mellitus, is characterized by insulin resistance (IR), elevated serum levels of free fatty acids and fatty infi ltration of the liver, which is known as hepatic steatosis. Hepatocyte apoptosis is a key feature of this disease and correlates with its severity. Free-fatty-acidinduced toxicity represents one of mechanisms for the pathogenesis of NAFLD and hormones, growth factors and adipokines influence also play a key role. This review highlights the various pathways that contribute to the development of hepatic steatosis. Circulating concentrations of inflammatory cytokines are reckoned to be the most important factor in causing and maintaining IR. Low-grade chronic inflammation is fundamental in the progression of NAFLD toward higher risk cirrhotic states.

Low-grade myofibroblastic sarcoma of the palate

Low-grade myofibroblastic sarcoma （LGMS） is a rare, malignant tumor with myofibroblastic differentiation. Despite it being classified as a distinct entity by the World Health Organization, a few cases were reported in the oral and maxillofacial region. Here, a LGMS developed on the palate of a 73-year-old man who presented with a 1-cm tumor on the posterior border of the palate. Based on the histological and immunohistochemical features, a diagnosis of LGMS was established. The tumor was resected, and no recurrence was observed over 2 years. Although the tongue is the most preferred site for LGMS, it may occur in any region of the oral cavity.

Even low-grade inflammation impacts on small intestinal function

Independent of the cause and location,inflammation-even when minimal-has clear effects on gastrointestinal morphology and function.These result in altered digestion,absorption and barrier function.There is evidence of reduced villus height and crypt depth,increased permeability,as well as altered sugar and peptide absorption in the small intestine after induction of inflammation in experimental models,which is supported by some clinical data.Identification of inflammatory factors which may promote the process of gastrointestinal dysfunction as well as clinical research to verify experimental observations of inflammatory modulation of gastrointestinal function are required.Moreover,nutritional strategies to support functional restitution are needed.

Extraction of valuable metals from low-grade nickeliferous laterite ore by reduction roasting-ammonia leaching method

Nickel and cobalt were extracted from low-grade nickeliferous laterite ore using a reduction roasting-ammonia leaching method.The reduction roasting-ammonia leaching experimental tests were chiefly introduced,by which fine coal was used as a reductant.The results show that the optimum process conditions are confirmed as follows:in reduction roasting process,the mass fraction of reductant in the ore is 10%,roasting time is 120 min,roasting temperature is 1 023-1 073 K;in ammonia leaching process,the liquid-to-solid ratio is 4:1(mL/g),leaching temperature is 313 K,leaching time is 120 min,and concentration ratio of NH3 to CO2 is 90 g/L:60 g/L.Under the optimum conditions,leaching efficiencies of nickel and cobalt are 86.25% and 60.84%,respectively.Therefore,nickel and cobalt can be effectively reclaimed,and the leaching agent can be also recycled at room temperature and normal pressure.

Roasting oxidation behaviors of ReS_2 and MoS_2 in powdery rhenium-bearing, low-grade molybdenum concentrate

The oxidation roasting process of molybdenum concentrate has significant advantages in industrial applications.However,utilization of low-grade mineral has many problems because it is more complex than the standard concentrate.In this study,the oxidation behaviors of powdery rhenium-bearing low-grade molybdenum concentrate were investigated through thermodynamic calculation,roasting experiments,thermogravimetric analysis,and phase analysis.The results obtained show that oxidation of MoS2 begins at 450℃,and MoO3 reacts with metal-oxide forming molybdate at 600℃.Finally,MoO3 can be dissolved in ammonia with a maximum content of approximately 80%.The volatile speed of Re was considerably slower than the oxidation speed of MoS2 because the nonvolatile products ReO2 and ReO3 were generated in reactions among MoS2,SO2,and Re2O7.The final volatilization rate of Re was almost 70%.This study determined the problems related to the roasting of low-grade molybdenum concentrate,which lays the scientific foundations for subsequent enhancement of molybdenum and rhenium extraction.

Transformation and leaching kinetics of silicon from low-grade nickel laterite ore by pre-roasting and alkaline leaching process

The mineralogical phase transformation of a low-grade nickel laterite ore during pre-roasting process and the extraction of silicon during alkaline leaching process were investigated.The results indicate that the reaction activity of nickel ores is effectively improved by pre-roasting at650°C for2h,because of the transformation of lizardite into magnesium olivine and protoenstatite.When finely ground ore samples(44-61μm)pre-roasted firstly react with sodium hydroxide solution(60g/L)with a solid/liquid ratio of1:5at140°C for120min,the extraction of silicon can reach89.89%,and the other valuable elements of magnesium,iron and nickel are accumulated in the solid residues.The leaching kinetics of nickel laterite ore can be described successfully by the diffusion through the product layer control model.The activation energy is calculated to be11.63kJ/mol and the kinetics equation can be expressed as1-3(1-x)2/3+2(1-x)=13.53×10-2exp[-11.63/(RT)]t.

Optimal management of biopsy-proven low-grade gastric dysplasia

Gastric adenocarcinoma generally culminates via the inflammation-metaplasia-dysplasia-carcinoma sequence progression. The prevalence of gastric adenomas shows marked geographic variation. Recently, the rate of diagnosis of low-grade dysplasia(LGD) has increased due to increased use of upper endoscopy. Many investigators have reported that gastric highgrade dysplasia has high potential for malignancy and should be removed; however, the treatment for gastric LGD remains controversial. Although the risk of LGD progression to invasive carcinoma has been reported to be inconsistent, progression has been observed during follow-up. Additionally, the rate of upgraded diagnosis in biopsy-proven LGD is high. Therefore, endoscopic resection(ER) may be useful in the treatment and diagnosis of LGD, especially if lesions are found to have risk factors for upgraded histology after ER, such as large size, surface erythema or depressed morphology. Fatal complications in endoscopic submucosal dissection(ESD) are extremely low and its therapeutic and diagnostic outcomes are excellent. Therefore, ESD should be applied preferentially instead of endoscopic mucosal resection.

Research on new beneficiation process of low-grade magnesite using vertical roller mill

We investigated whether the vertical roller mill can be efficiently used in the beneficiation of low-grade magnesite and whether it can improve upon the separation indices achieved by the ball mill.We conducted experiments involving the reverse flotation and positive flotation of low-grade magnesite to determine the optimum process parameters,and then performed closed-circuit beneficiation experiments using the vertical roller mill and ball mill.The results show that the optimum process parameters for the vertical roller mill are as follows:a grinding fineness of 81.6wt%of particles less than 0.074 mm,a dodecyl amine(DDA)dosage in magnesite reverse flotation of 100 g·t?1,and dosages of Na2CO3,(NaPO3)6,and NaOL in the positive flotation section of 1000,100,and 1000 g·t?1,respectively.Compared with the ball mill,the use of the vertical roller mill in the beneficiation of low-grade magnesite resulted in a 1.28%increase in the concentrate grade of MgO and a 5.88%increase in the recovery of MgO.The results of our causation mechanism analysis show that a higher specific surface area and greater surface roughness are the main reasons for the better flotation performance of particles ground by the vertical roller mill in the beneficiation of lowgrade magnesite.