Long-term outcomes of anti-VEGF treatment with 5+PRN regimen for macular edema due to central retinal vein occlusion

AIM:To assess the long-term outcomes of treating macular edema(ME)associated with central retinal vein occlusion(CRVO)with a regimen of“5+pro re nata(PRN)”.METHODS:This retrospective study included 27 eyes of 27 patients with ME associated with non-ischemic CRVO(non-iCRVO group,n=15)and ischemic CRVO(iCRVO group,n=12).The eyes were treated with five consecutive intravitreal injections of conbercept or ranibizumab,followed by reinjections as needed or PRN.Retinal laser photocoagulation or intravitreal dexamethasone implants(DEX)were implemented in both groups when necessary.The best-corrected visual acuity(BCVA,logMAR)and central retinal thickness(CRT)were recorded at baseline,at 1,2,3,4,5,6,and 12mo,and at the final visit.The efficacy rates of BCVA and CRT before and after treatment were calculated.The number of injections at each visit and the incidence of adverse events were also recorded.RESULTS:The patients,aged 59.4±15.1y,were followed up for 24.7±8.8mo(range:15-42mo).After treatment,BCVA improved significantly from 1.04±0.56 logMAR at baseline to 0.59±0.36 logMAR(P=0.038)at the final visit in all patients.Both the non-iCRVO and the iCRVO groups achieved improved BCVA compared to the baseline at all visit points,but there was no statistical significance(P=0.197 and 0.33,respectively).The mean CRT was statistically reduced compared to baseline at all visit points in all the eyes and in both groups(all P<0.001).The apparent effective rate was 22.22% for BCVA and 37.04% for CRT after the first injection,48.15%for BCVA and 62.96% for CRT after 5 consecutive injections,and 74.08% for BCVA and 100% for CRT at the end of follow up.The average number of injections in all patients was 9.0±2.4 at 12mo and 14.9±8.1 finally with no statistical significance between both groups(P>0.05).Laser treatment was applied to all eyes in the iCRVO group,while only 5 patients in the noniCRVO group.Six patients in the non-iCRVO group and 3 patients in the iCRVO group had a drug switch.DEX was applied to 4 eyes in the non-iCRVO group and 5 eyes in the iCRVO group.CONCLUSION:The 5+PRN anti-vascular endothelial growth factor(VEGF)regimen is found to be safe and effective for both iCRVO and non-iCRVO,especially in the iCRVO group.The best regimen for such patients needs to be further investigated.Adjuvant laser therapy and DEX are necessary in some cases.

Temporal and Spatial Distribution of SARS-CoV-2 Aerosols in a Large-Scale Fangcang Shelter Hospital in Shanghai,China

The coronavirus disease 2019(COVID-19)pandemic caused by frequently mutating severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)has had a worldwide impact.However,detailed data on the potential aerosol transmission of SARS-CoV-2 in real-world and controlled laboratory settings remain sparse.During the COVID-19 pandemic in Shanghai,China in 2022,samples were collected in a Fangcang shelter hospital,a large-scale temporary hospital rapidly built by converting the existing National Exhibition and Convention Center(Shanghai)into a health care facility.Aerosol samples at different sites and intervals around patients and in public areas,surface samples,and pharyngeal swab samples from corresponding patients were included.Samples were tested for SARS-CoV-2 using real-time quantitative polymerase chain reaction(RT-qPCR)assays,followed by sequencing if the cycle threshold(Ct)value was<30.The positivity rate for SARS-CoV-2 in aerosol samples was high in contaminated zones(37.5%,104/277),especially around the bed(41.2%,68/165)and near ventilation inlets(45.2%,14/31).The prevalence of SARS-CoV-2 around the bed,public areas,and air inlets of exhaust vents fluctuated and was closely related to the positivity rate among patients at corresponding sampling sites.Some surface samples of different personal protective equipment from medical staff had high positivity rates.Sixty sequences of joined ORF1ab and spike genes obtained from sixty samples represented two main clusters of Omicron SARS-CoV-2.There was consistency in virus sequences from the same patient and their environment,and the detected virus sequences matched those of virus strains in circulation during the collection periods,which indicated a high likelihood of cross-contamination in the Fangcang shelter hospital.In summary,the results provide a quantitative and real landscape of the aerosol transmission of SARS-CoV-2 and a patient-centered view of contamination in large and enclosed spaces and offer a useful guide for taking targeted measures to avoid nosocomial infections during the management of SARS-CoV-2 or other respiratory virus diseases in a Fangcang shelter hospital.

Influencing factors of ocular pain in dry eye disease patients at high altitude

AIM:To quantify the severity and frequency of ocular pain in Tibetan plateau patients with dry eye,and to evaluate the related factors affecting ocular pain.METHODS:A retrospective study included 160 cases of dry eye disease(DED)patients who were treated from July 2022 to June 2023.Age,gender,occupation,illness course,anxiety,plateau duration,plateau protection,ocular surface disease index scale(OSDI),break-up time(BUT),Schirmer I test(SIT),conjunctivitis,history of ophthalmic medication,autoimmune disease,the workload of daily near vision range,smoking and overnight stay were obtained via comprehensive ophthalmic assessment,and their duration was followed up.Logistic regression analysis was used to determine the related factors affecting ocular pain.RESULTS:Totally 77.5%(124/160)of DED patients had ocular pain,of which the severity of ocular pain was mild,moderate,and severe in 30.0%,36.3%,and 11.3%of patients,respectively.Frequency of ocular pain was reported occasional,half the time,frequent,and persistent pain in 19.4%,36.9%,16.9%,and 4.4%.OSDI score was 19.67±5.70(13 to 36),and the level of pain was lowly correlated with OSDI(rs=0.316,P<0.001).Logistic regression showed that in plateau DED patients,increased anxiety led to increased severity and frequency of ocular pain[odds ratio(OR)=3.662,5.613,2.387,and 4.870;all P<0.05],professional eye protection and improvement of daily sleep quantity decreased pain(OR=0.307,0.572,0.418,and 0.789;all P<0.05),while smoking and general protection of plateau did not affect the severity and frequency of ocular pain(all P>0.05).CONCLUSION:Ocular pain is a common complaint in high-altitude DED patients during the pandemic.Anxiety,eye protection,and adequate sleep during the epidemic period are significantly associated with the severity and frequency of ocular pain in patients with plateau DED,while symptoms of DED have relatively little influence on them.

Clinical effect of spleen aminopeptide on improving liver function damage and immune function in children with infant hepatitis syndrome

BACKGROUND Infant hepatitis syndrome(IHS)is a clinical syndrome in infants less than one year of age with generalized skin jaundice,abnormal liver function,and hepato-megaly due to various etiologies such as infection.AIM To investigate the effect of IHS patients,after treatment with arsphenamine-based peptides,on patients'liver function damage and immune function.METHODS Of 110 patients with IHS treated in our hospital from January 2019 to January 2021 were grouped according to the randomized residual grouping method,with 5 cases in each group shed due to transfer,etc.Ultimately,50 cases remained in each group.The control group was treated with reduced glutathione,and the treat-ment group was treated with sesquiterpene peptide based on the control group.Observe and compare the differences in indicators after treatment.RESULTS The comparison of serum total bilirubin,direct bilirubin,and serum alanine transferase after treatment was significantly different and lower in the treatment group than in the control group(P<0.05).The comparison of CD4+,CD3+,CD4+/CD8+after treatment was significantly different and higher in the treatment group than in the control group,and the comparison was statist-ically significant(P<0.05).The complication of the two groups showed that the rash,cough and sputum,elevated platelets,and gastrointestinal reactions in the treatment group were significantly lower than those in the control group,and the differences were statistically significant by test(P<0.05).CONCLUSION The comparative study of IHS treated with arsphenamine combined with reduced glutathione is more effective.

Clinical efficacy,bone density,and follow-up in implant and orthodontic treatment for inclined adjacent teeth

BACKGROUND Tooth defects can cause elongation of occlusal teeth,leading to insufficient repair space.The combination of dental implant restoration and orthodontic treatment of oblique adjacent teeth has a significant therapeutic effect.AIM To explore clinical efficacy,bone density,and follow-up of implant and orthodontic treatment for patients with inclined adjacent teeth.METHODS In total,98 patients with oblique adjacent teeth were randomly assigned to implant restoration combined with orthodontic treatment(group A,n=49)or to receive implant restoration alone(group B,n=49).Changes in alveolar ridge bone density and apical bone density were observed before and after treatment in the two groups.Changes in chewing function and language function were compared between the two groups of patients.Follow-up lasted for 12 mo after repair to observe any adverse reactions in the oral cavity.RESULTS The clinical effective rates of group A and group B were 97.96%and 85.71%,respectively,with group A having a higher clinical effective rate than group B.After treatment,the bone density of the alveolar ridge and apical bone in both groups decreased compared to before treatment,while the chewing and language functions improved.The changes in various indicators in group A were more significant.After treatment,the satisfaction rate of group A(97.96%)was higher than that of group B(79.59%).The incidence of adverse reactions in group A(2.04%)was lower than that in group B(24.49%).CONCLUSION The amalgamation of implant restoration and orthodontic treatment for adjacent tilted teeth demonstrates notable clinical efficacy,diminishes alveolar bone resorption,and fosters patient functional rehabilitation while exhibiting negligible adverse reactions.

Comparison of Efficacy between 3D Navigation-Assisted Percutaneous Iliosacral Screw and Minimally Invasive Reconstruction Plate in Treating Sacroiliac Complex Injury

The clinical efficacy was compared between 3D navigation-assisted percutaneous iliosacral screw(3DPS)and minimally invasive reconstruction plate(MIRP)in treating sacroiliac complex injury and the surgical procedures of 3DPS were introduced.A retrospective analysis was performed on 49 patients with sacroiliac complex injury from March 2013 to May 2017.Twenty-one cases were treated by 3DPS,and 28 cases by MIRP.Intraoperative indexes as operative time,blood loss,incision length,length of hospital stay and postoperative complications were respectively documented.Quality of reduction was postoperatively evaluated by Matta radiological criteria,and clinical effect was assessed by Majeed scoring criteria at the last followup.Operative time and hospital stay were significantly shortened,and blood loss,and incision length were significantly reduced in 3DPS group as compared with those in MIRP group(P<0.05).No statistically significant difference was found between 3DPS group and MIRP group in the assessment of reduction and function(P>0.05).It was concluded that both 3DPS and MIRP can effectively treat the sacroiliac complex injury,and 3DPS can provide an accurate,safe and minimally invasive fixation with shorter operative time and hospital stay.

Long-term outcomes of drusenoid pigment epithelium detachment in intermediate AMD treated with 577 nm subthreshold micropulse laser: a preliminary clinical study

AIM: To evaluate the long-term anatomical and visual outcomes of drusenoid pigment epithelial detachment(D-PED) in intermediate age-related macular degeneration(AMD) eyes treated with 577 nm yellow subthreshold micropulse laser(SML).METHODS: In this retrospective study, 21 eyes of 16 patients with D-PED in intermediate AMD were consecutively included and assessed.All the eyes were treated with 577 nm SML in several sessions according to D-PED growth status.The logarithm of the minimum angle of resolution(logMAR) best-corrected visual acuity(BCVA) were assessed at the initial visit and after treatment.Spectral-domain optical coherence tomography(SD-OCT) was performed to evaluate the D-PED lifecycle by volumetric calculations.Regression analysis was used to determine the breakpoint, growth, and collapse rate of the D-PED lesions.The progression to advanced AMD was also documented.RESULTS: All the eyes were treated with SML for 2.9±1.0 sessions.The mean follow-up period was 25.3±12.6 mo.The BCVA was stable from the baseline to final visit.All the eyes were categorized into two groups according to the anatomical changes of the D-PED lesion: the collapse group(n=6, 28.6%) and non-collapse group(n=15, 71.4%).The change in logMAR BCVA did not differ significantly between the collapse group 0.00(-0.31, 0.85) and non-collapse group 0.00(0.00, 0.00;P=1).Regression analysis showed that the growth rate was significantly higher in the collapse group(0.090±0.095 mm;/mo) than in the non-collapse group(0.025±0.035 mm;/mo;P<0.001).One eye(4.8%) developed macular neovascularization at 11 mo after SML treatment in the non-collapse group.Three eyes(14.3%) developed geographic atrophy(GA) in the collapse group.CONCLUSION: Compared to the natural course of D-PED reported by previous studies, our results preliminarily show that SML can alleviate visual loss and possibility of progression to advanced AMD in eyes with D-PED in intermediate AMD.A controlled clinical trial needs to further verify the benefit of the intervention.

Preparation and Characterization of Poly Lactic Acid/Graphene Oxide/Nerve Growth Factor Scaffold with Electrical Stimulation for Peripheral Nerve Regeneration in vitro

A novel conductive drug-loading system was prepared by using an improved emulsion electrostatic spinning method which contained polylactic acid (PLA),graphene oxide (GO),and nerve growth factor (NGF) coated with bovine serum albumin (BSA) nanoparticles.Firstly,the structure,mechanical properties,morphology and electrical conductivity of PLA/GO electro spun fiber membranes with different GO ratios were characterized.PLA/GO scaffolds can exhibit superior porosity,hydrophilic and biomechanical properties when the GO incorporation rate is 0.5%.The addition of GO in the PLA/GO electro spun fiber membranes can also create appropriate pH environment for the repair of injured nerve when the GO incorporation rate is above 0.5%.Secondly,PLA/GO/BSA/Genipin/NGF particles (with a ratio of BSA/NGF=3:1) prepared by modified emulsion electro spinning method will release more NGF than PLA/GO/NGF particles.In addition,PLA/0.5%GO/NGF scaffold can maintain its structure stability for at least 8 weeks observed by scanning electron microscope (SEM).Moreover,the degradation of PLA/0.5%GO/NGF scaffold is consistent with its weight loss.Finally,in vitro assay confirmes that PLA/GO composite scaffold exhibits low cytotoxicity to RSC96 cells.Cellular results have demonstrated that PLA/0.5%GO/NGF sustained-release drug sustained-release system with appropriate electrical stimulation (ES) can promote PC12 cell proliferation,and it can maintain its differentiation capability for at least 3 weeks.In conclusion,PLA/0.5%GO/NGF sustained-release drug sustained-release system can maintain its biological activity for at least 3 weeks and promote cell proliferation with appropriate ES.

Association Between Lipid Profiles and Left Ventricular Hypertrophy:New Evidence from a Retrospective Study

Objective To explore the association between lipid profiles and left ventricular hypertrophy in a Chinese general population.Methods We conducted a retrospective observational study to investigate the relationship between lipid markers[including triglycerides,total cholesterol,low-density lipoprotein cholesterol,high-density lipoprotein(HDL)cholesterol,non-HDL-cholesterol,apolipoprotein A-I,apolipoprotein B,lipoprotein[a],and composite lipid profiles]and left ventricular hypertrophy.A total of 309,400 participants of two populations(one from Beijing and another from nationwide)who underwent physical examinations at different health management centers between 2009 and 2018 in China were included in the cross-sectional study.7,475 participants who had multiple physical examinations and initially did not have left ventricular hypertrophy constituted a longitudinal cohort to analyze the association between lipid markers and the new-onset of left ventricular hypertrophy.Left ventricular hypertrophy was measured by echocardiography and defined as an end-diastolic thickness of the mterventricular septum or left ventricle posterior wall>11 mm.The Logistic regression model was used in the cross-sectional study.Cox model and Cox model with restricted cubic splines were used in the longitudinal cohort.Results In the cross-sectional study for participants in the highest tertile of each lipid marker compared to the respective lowest,triglycerides[odds ratio(OR):1.2S0,95%CI:1.060 to 1.474],HDL-cholesterol(OR:0.780,95%CI:0.662 to 0.918),and lipoprotein(a)(OR:1.311,95%C7:1.115 to 1.541)had an association with left ventricular hypertrophy.In the longitudinal cohort,for participants in the highest tertile of each lipid marker at the baseline compared to the respective lowest,triglycerides[hazard ratio(HR):3.277,95%C/:1.720 to 6.244],HDL-cholesterol(HR:0.516,95%C7:0.283 to 0.940),non-HDL-cholesterol(HR:2.309,95%C/:1.296 to 4.112),apolipoprotein B(HR:2.244,95%CI:1.251 to 4.032)showed an association with new-onset left ventricular hypertrophy.In the Cox model with forward stepwise selection,triglycerides were the only lipid markers entered into the final model.Conclusion Lipids levels,especially triglycerides,are associated with left ventricular hypertrophy.Controlling triglycerides level potentiate to be a strategy in harnessing cardiac remodeling but deserve to be furdier investigated.

Transcriptional Regulation of YP3680 by Rov A and Rcs AB in Yersinia pestis biovar Microtus

Type-VI secretion system(T6SS)is a widespread bacteriophage-like complex in bacteria that participates in multiple physiological processes,including metal ion uptake,bacterial competition,and biofilm formation^([1]).Yersinia pestis is the causative agent of plague.There are five T6SS gene clusters in Y.pestis CO92.

A cross-sectional study of olfactory and taste disorders among COVID-19 patients in China

To determine the prevalence and clinical features of olfactory and taste disorders among coronavirus disease 2019(COVID-19)patients in China.A cross-sectional study was performed in Wuhan from April 3,2020 to April 15,2020.A total of 187 patients with confirmed severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)completed face-to-face interviews or telephone follow-ups.We found that the prevalence of olfactory and taste disorders was significantly lower in the Chinese cohort than in foreign COVID-19 cohorts.Females were more prone to olfactory and taste disorders.In some patients,olfactory and taste disorders precede other symptoms and can be used as early screening and warning signs.

ZYX promotes invasion and metastasis of gastric cancer cells via WNK1/SNAI1axis

Gastric cancer(GC)is the third most common cause of cancer death globally and a large portion of patients are diagnosed at advanced stages with cancer invasion and metastasis1,2.However,the mechanisms underlying the invasion and metastasis of GC remain to be delineated.ZYX plays critical roles in cell mobility via cytoskeleton regulation in various cell types.3 In this study,we further reported that ZYX promoted migration,invasion,and metastasis of GC cells.Mechanistically,ZYX promoted WNK1 activation and SNAl1 up-regulation,inducing epithelial-mesenchymal transition(EMT)to enhance the mobility of GC cells.Inhibition of WNK1 impaired the mobility of GC cells.Therefore,ZYX/WNK1 could be potential therapeutic targets for GC treatment.

计算机辅助联合吲哚菁绿分子荧光影像技术在肝脏肿瘤诊断和手术导航中的应用指南（2019版）（英文）

计算机辅助联合吲哚菁绿分子荧光影像技术可以从三维的形态解剖和细胞功能水平进行术前规划和术中侦测,从而导航肝癌解剖性、功能性、根治性的肝切除术,临床应用证明其有重要的诊疗价值,此项技术现已在全国得到了广泛推广和应用。为规范计算机辅助联合吲哚菁绿分子荧光影像技术在肝脏肿瘤精准诊疗中的应用,本指南在以下几个方面进行了研究:(1)三维可视化技术应用流程;(2)ICG分子荧光成像的机制及应用流程;(3)三维可视化和虚拟现实技术的临床应用;(4)ICG分子荧光影像技术的临床应用。ICG分子荧光成像技术能从分子、细胞水平层面实现肿瘤边界界定、肝段和肝叶切除切线的确定;微小病灶或转移灶的侦测;术中根据肝脏肿瘤的荧光信号特点,结合术中快速冰冻病理学检查,可初步判定肝脏占位性病变的分化程度;肝切除后对肝断面进行残留肿瘤病灶和胆漏的检测。计算机辅助联合ICG分子荧光影像技术在肝脏肿瘤诊断和手术导航中的应用,为肝脏肿瘤的外科治疗提供了一种新的数字智能化外科诊疗技术,该项技术亦将不断改进和完善,为肝脏肿瘤的精准诊疗展现出良好的应用前景。

Preventive strategies for feeding intolerance among patients with severe traumatic brain injury:A cross-sectional survey

This study aimed to investigate the application status of preventive measures for feeding intolerance in patients with severe traumatic brain injury(STBI)in China and analysis the differences and their causes.Methods A cross-sectional survey was conducted.From December 2019 to January 2020,ICU nurses and physicians of 89 hospitals in China were surveyed by using a questionnaire on preventive strategies for feeding intolerance in patients with STBI.The questionnaire included two parts:the general information of participants(10 items)and application of preventive measures for feeding intolerance in STBI patients(18 items).Results Totally 996 nurses and physicians completed the questionnaire.Among various methods,gastrointestinal symptoms(85.0%)and injury severity(71.4%)were mostly used to assess gastrointestinal functions and risk of feeding intolerance among STBI patients,respectively.Initiating enteral nutrition(EN)within 24–48 h(61.5%),nasogastric tubes(91.2%),30°–45°of head-of-bed elevation(89.5%),continuous feeding by pump(72.9%),EN solution temperature of 38–40°C(65.5%),<500 ml initial volume of EN solution(50.0%),monitoring gastric residual volume with a syringe(93.7%),and assessing gastric residual volume every 4 h(51.5%)were mostly applied for EN delivery among STBI patients.Prokinetic agents(73.3%),enema(73.6%),probiotics(79.0%),antacid agents(84.1%),and non-nutritional preparations as initial EN formula(65.6%)were commonly used for preventing feeding intolerance among STBI patients.Conclusions The survey showed that nurses and clinicians in China have a positive attitude towards preventive strategies for feeding intolerance.However,some effective new technologies and methods have not been timely applied in clinical practice.We suggest that managers,researchers,clinicians,nurses,and other health professionals should collaborate to explore effective and standard preventive strategies for feeding intolerance among patients with STBI.

Survival after radical cystectomy for bladder cancer:Multicenter comparison between minimally invasive and open approaches

Objective:To investigate oncological outcomes in patients with bladder cancer who underwent minimally invasive radical cystectomy(MIRC)or open radical cystectomy(ORC).Methods:We identified patients with bladder cancer who underwent radical cystectomy(RC)in 13 centers of the Chinese Bladder Cancer Consortium(CBCC).Perioperative outcomes were compared between MIRC and ORC.The influence of surgical approaches on overall survival(OS)and cancer-specific survival(CSS)in the entire study group and subgroups classified according to pathologic stage or lymph node(LN)status was assessed with the log-rank test.Multivariable Cox proportional hazard models were used to evaluate the association among OS,CSS and risk factors of interest.Results:Of 2098 patients who underwent RC,1243 patients underwent MIRC(1087 laparoscopic RC and 156 robotic-assisted RC,respectively),while 855 patients underwent ORC.No significant differences were noted in positive surgical margin rate and 90-day postoperative mortality rate.MIRC was associated with less estimated blood loss,more LN yield,higher rate of neobladder diversion,longer operative time,and longer length of hospital stay.There was no significant difference in OS and CSS according to surgical approaches(pZ0.653,and 0.816,respectively).Subgroup analysis revealed that OS and CSS were not significantly different regardless of the status of extravesical involvement or LN involvement.Multivariable Cox regression analyses showed that the surgical approach was not a significant predictor of OS and CSS.Conclusions:Our study showed that MIRC was comparable to conventional ORC in terms of OS and CSS.

Effect of Different Factors on the Quality of Life and Sequelae of COVID-19 Patients After Discharge

Background The continued spread of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)remains an international public health emergency,resulting in a significant global disease burden.The long-term effects of SARS-CoV-2 infection in humans and the long-term prognosis of patients with coronavirus disease 2019(COVID-19)after discharge remain unclear.We aimed to assess the quality of life(QoL)and sequelae in patients with COVID-19 after discharge from the hospital by conducting multiple follow-up visits to understand the long-term effects of SARS-CoV-2 on patients'health and its possible influencing factors.Methods COVID-19 patients discharged from Huoshenshan Hospital(Wuhan,China)between February 15 and April 5,2020,were followed up at 6,9,and 12 months after discharge.They completed questionnaires on postdischarge QoL and sequelae under the guidance of medical staff with professional training.The demographic and clinical characteristics of the COVID-19 patients were analyzed using descriptive statistics.A generalized estimating equation model was used to analyze the QoL-related factors.Theχ2 test(or Fisher exact test)and multivariate logistic regression analysis were used to analyze the sequelae and influencing factors.Results A total of 175 patients participated in at least 1 follow-up visit,and 120 completed all 3 follow-up visits.Patients diagnosed with severe and critically ill COVID-19 had worse mental conditions(χ2=7.653,P=0.022)than those with the nonsevere type(not severe or critical)and were more likely to feel fatigued(χ2=4.836,P=0.028).Female patients had a higher risk of sleep disturbance(χ2=10.026,P=0.002)and dyspnea(χ2=5.672,P=0.017)and had more difficulty returning to their original work and life(χ2=8.922,P=0.003)than male patients.Patients with diabetes had a worse appetite(χ2=4.669,P=0.031)and were more prone to sleep disturbance(χ2=4.417,P=0.036)after discharge.The proportion of patients with at least 1 sequela increased from 29.76%(50/168)at 6 months to 51.11%(69/135)at 9 months(χ2=14.305,P<0.001).Compared with the nonsevere type,patients diagnosed with severe and critically ill COVID-19 had an odds ratio(OR)of 4.325(95%confidence interval[CI],1.215–15.401)for memory decline.Female patients had an OR of 4.632(95%CI,1.716–12.501)for joint or muscle pain.Patients with hypertension had an OR of 3.014(95%CI,1.193–7.615)for joint or muscle pain.Conclusion One year after discharge,there were still some patients with varying degrees of decline in QoL and sequelae,which occurred in all follow-up visits.Moreover,QoL and sequelae after discharge were related to sex,clinical classification of COVID-19,and underlying diseases.

Computer-aided recognition and assessment of a porous bioelastomer in ultrasound images for regenerative medicine applications

It is difficult to use a single edge operator in image processing to extract continuous and accurate contours of a porous bioelastomer due to the fuzzy boundary and complex background in ultrasound images.To solve this problem,this paper proposes a joint algorithm for bioelastomer contour detection and a texture feature extraction method for monitoring the degradation performance of bioelastomers.First,the mean-shift clustering method is utilized to obtain the clustering feature information of bioelastomers and native tissue from manually segmented images,and this information is used as the initial information in the image binarization algorithm for image partitioning.Second,Otsu's thresholding method and mathematical morphology are applied in the process of image binarization.Finally,the Canny edge detector is employed to extract the complete bioelastomers contour from the binary image.To verify the robustness of the proposed joint algorithm,the results using the proposed joint algorithm,where mean-shift clustering is replaced with k-means clustering are also obtained.The proposed joint algorithm based on mean-shift clustering outperforms the joint algorithm based on k-means clustering,as well as algorithms that directly apply the Canny,Sobel and Laplacian methods.Texture feature extraction is based on the computer-aided recognition of bioelastomers.The region of interest(ROI)is set in the scaffold region,and the first-order statistical features and second-order statistical features of the greyscale values of the ROI are extracted and analysed.The proposed joint algorithm can not only extract ideal bioelastomers contours from ultrasound images but also provide valuable feedback on the degradation behaviour of bioelastomers at implant sites.

From Environmental Toxicants to Antibacterial Agents:BPA Analogues Selectively Inhibit the Growth of Gram-Positive Bacteria by Disturbing Biosynthesis of the Cell Wall

Remarkable antibacterial activity of BPA analogues especially for tetrabromobi-sphenol A against Staphylococcus aureus 25923(Sa25923)and methicillin-resistant Staphylococcus aureus(MRSA)has been reported in our previous studies.However,the toxic effects of the compounds as environmental contaminants on the endocrine system limited their applications in the field of medicine and health.Given the abuse of antibiotics has led to the emergence of multiple super-resistant bacteria,we considered that structural modifications based on the BPA structure will be available for molecular designing of potential antimicrobial agents without drug resistance.In this study,to further improve the antibacterial activity and reduce the biological toxicity,we performed the computational models to evaluate the binding affinities of BPA analogues to the potential target DltA protein in the biosynthesis of cell wall.A series of synthesized achiral analogues ofα,α,α′-tris(4-hydroxyphenyl)-1-ethyl-4-isopropylbenzene(α,α,α′-TEIB)exhibited low minimum inhibitory concentration against Sa25923 and MRSA(2 or 1μg mL−1).Especially,the analogue A4 did not induce the drug-resistant mutants for all tested Gram-positive bacterial strains and exhibited relatively lower cytotoxicity in HepG2 cells.The developed classification model based on the light gradient boosting algorithm showed the superior performances on the internal robustness and generalization ability for the ligand-based virtual screening of bisphenol and polyphenol antimicrobial substances.Collectively,our findings suggest that the molecular structure ofα,α,α′-TEIB is promising as a scaffold,which is expected to achieve a breakthrough in the development of antibiotics which can prevent the invasion of MRSA and other super bacteria.

Lymphopenia predicts disease severity of COVID-19:a descriptive and predictive study

Dear Editor,An outbreak of an unknown infectious pneumonia has recently occurred in Wuhan,China.1 The pathogen of the disease was quickly identified as a novel coronavirus(SARS-CoV-2,severe acute respiratory syndrome coronavirus 2),and the disease was named coronavirus disease-19(COVID-19).2 The virus has so far caused 78,959 confirmed cases and 2791 deaths in China according to the reports of government.COVID-19 has been spreading in many countries such as Japan,Korea,Singapore,Iran,and Italia.

Effect of human umbilical cord-derived mesenchymal stem cells on lung damage in severe COVID-19 patients:a randomized,double-blind,placebo-controlled phase 2 trial

Treatment of severe Coronavirus Disease 2019(COVID-19)is challenging.We performed a phase 2 trial to assess the efficacy andsafety of human umbilical cord-mesenchymal stem cells(UC-MScs)to treat severe coViD-19 patients with lung damage,based onour phase 1 data.In this randomized,double-blind,and placebo-controlled trial,we recruited 101 severe coVID-19 patients withlung damage.They were randomly assigned at a 2:1 ratio to receive either UC-MSCs(4×10^(7)cells per infusion)or placebo on day 0,3,and 6.The primary endpoint was an altered proportion of whole lung lesion volumes from baseline to day 28.Other imagingoutcomes,6-minute walk test(6-MWT),maximum vital capacity,diffusing capacity,and adverse events were recorded and analyzed.In all,100 COVID-19 patients were finally received either UC-MSCs in=65)or placebo(n=35).UC-MSCs administrationexerted numerical improvement in whole lung lesion volume from baseline to day 28 compared with the placebo(the mediandifference was-13.31%,95%Cl-29.14%,2.13%,P=0.08).UC-MSCs significanty reduced the proportions of solid componentlesion volume compared with the placebo(median difference:-15.45%;95%CI-30.82%,-0.39%;P=0.043).The 6-MWT showedan increased distance in patients treated with UC-MSCs(difference:27.00 m;95%CI 0.00,57.00;P=0.057).The incidence of adverseevents was similar in the two groups.These results suggest that UC-MSCs treatment is a safe and potentially effective therapeuticapproach for COVID-19 patients with lung damage.A phase 3 trial is required to evaluate effects on reducing mortality andpreventing long-term pulmonary disability.