Objective. To explore the clinical characteristics of patients with different severity in the early outbreak of COVID-19, hoping to provide reference for clinical diagnosis and treatment. Methods. We ...retrospectively analyzed the clinical data of 95 COVID-19 patients in Wuhan Red Cross Hospital of China from January 17 to February 13, 2020. All patients were investigated with epidemiological questionnaires. Outcomes were followed up until April 1, 2020. Results. There were 53 males and 42 females, aged 22–84 years (mean 57.3 years). Clinical classification included 54 cases of common type, 27 cases of severe type, and 14 cases of critical type. Six patients had been exposed to the local Huanan seafood market. There were 38 clusters of COVID-19, including 27 family clusters and 11 work unit clusters. Common symptoms included fever (86 (90.5%) of 95), cough (73 (76.8%)), and fatigue (50 (52.6%)). Laboratory findings showed that the most common abnormalities were lymphopenia (75 (78.9%)), elevated D-dimer (60 (63.2%)), and elevated C-reactive protein (56 (58.9%)) on admission. All patients had abnormal chest computed tomography, showing patchy shadows or ground-glass opacities. Severe and critical cases were older, more likely to have shortness of breath, more likely to have underlying comorbidities, and more likely to have abnormal laboratory findings than common cases. The prognosis of patients with different degrees of severity was significantly different. All common and severe patients (100%) were cured and discharged from the hospital, while 10 (71.4%) of 14 critical patients died. Conclusions. COVID-19 has fast transmission speed and high pathogenicity. We must assess the severity of the disease and take corresponding treatment measures as early as possible.
A provisional surface reflectance (SR) product from the Advanced Himawari Imager (AHI) on-board the new generation geostationary satellite (Himawari-8) covering the period between July 2015 and ...December 2018 is made available to the scientific community. The Multi-Angle Implementation of Atmospheric Correction (MAIAC) algorithm is used in conjunction with time series Himawari-8 AHI observations to generate 1-km gridded and tiled land SR every 10 minutes during day time. This Himawari-8 AHI SR product includes retrieved atmospheric properties (e.g., aerosol optical depth at 0.47µm and 0.51µm), spectral surface reflectance (AHI bands 1–6), parameters of the RTLS BRDF model, and quality assurance flags. Product evaluation shows that Himawari-8 AHI data on average yielded 35% more cloud-free, valid pixels in a single day when compared to available data from the low earth orbit (LEO) satellites Terra/Aqua with MODIS sensor. Comparisons of Himawari-8 AHI SR against corresponding MODIS SR products (MCD19A1) over a variety of land cover types with the similar viewing geometry show high consistency between them, with correlation coefficients (r) being 0.94 and 0.99 for red and NIR bands, respectively. The high-frequency geostationary data are expected to facilitate studies of ecosystems on daily to diurnal time scales, complementing observations from networks such as the FLUXNET.
Traumatic brain injury (TBI) could highly induce coagulopathy through breaking the dynamic balance between coagulation and fibrinolysis systems, which may be a major contributor to the progressive ...secondary injury cascade that occurs following TBI. Phosphatase and tensin homolog deleted on chromosome ten (PTEN) inhibition is reported to exert neuroprotective in TBI, making it a potential regulatory target involved in TBI-induced coagulation disorder. PTEN level is controlled in a major way by E3 ligase-mediated degradation through the ubiquitin-proteasome system. The C Terminus of Hsc70-interacting Protein (CHIP) has been shown to regulate proteasomal degradation and ubiquitination level of PTEN. In the present study, CHIP was overexpressed and knocked down in mouse brain microvascular endothelial cells (bEnd.3) and tissues during the early phase of TBI. In vitro cell proliferation, cell apoptosis, migration capacity, and invasion capacity were determined. The changes of procoagulant and apoptosis molecules after TBI were also detected as well as the micrangium density and blood brain barrier (BBB) permeability after in vivo TBI. In vitro results demonstrated that CHIP overexpression facilitated bEnd.3 cells proliferation, migration and invasion, downregulated cell apoptosis and the expressions of procoagulant molecules through promoting PTEN ubiquitination in an simulated TBI model with stretch-induced injury treatment. In vivo experiments also demonstrated that CHIP overexpression suppressed post-TBI apoptosis and procoagulant proteins expressions, as well as increased microvessel density, reduced hemorrhagic injury and BBB permeability. These finding suggested that the upregulation of CHIP may attenuate apoptosis and procoagulant activity, facilitate brain repair and thus exerts neuroprotective effects in TBI.
► Low molecular weight heparin-all-trans-retinoid acid (LHR) conjugate was developed. ► Studies showed that it was a safe material for intravenous administration. ► LHR conjugate could self-assemble ...to form nanoparticles for loading paclitaxel (PTX). ► PTX-loaded LHR nanoparticles displayed enhanced PTX-induced cytotoxicity and an extended circulation of PTX and ATRA.
As a novel nanocarrier for simultaneous delivery of multiple anticancer drugs, low molecular weight heparin-all-trans-retinoid acid (ATRA) (LHR) conjugate was developed. Amphiphilic LHR conjugate had markedly lower anticoagulant activity, and could self-assemble to form nanoparticles for loading hydrophobic drugs. The critical aggregation concentrations of LHR conjugates were varied from 407 to 40mg/L. Paclitaxel (PTX)-loaded LHR nanoparticles were prepared by the dialysis method, with particle sizes in the range of 228.0–108.9nm. The maximum drug-loading was as much as 33.1% with an entrapment efficiency of 93.1%. They displayed enhanced PTX-induced cytotoxicity to HepG2 cells compared to PTX solution. Hemolysis and cytotoxicity studies showed that LHR conjugate was a safe material for intravenous administration. Moreover, the pharmacokinetic profiles indicated that PTX-loaded LHR nanoparticles contributed to an extended circulation of PTX and ATRA. These results suggest that PTX-loaded LHR nanoparticles can be considered as promising anticancer drug delivery system for combination chemotherapy.
Purulent meningitis refers infection of the subarachnoid space by various purulent bacteria and the corresponding inflammation of the leptomeninges. However, purulent meningitis due to Rhodococcus ...equi is extremely rare.
A 40-year-old man presented with fever and intermittent headache for 6 days. Two hours prior to admission, he developed epileptic seizures.
Brain computed tomography and magnetic resonance imaging showed intracerebral malacic lesions. Bacterial culture of cerebrospinal fluid revealed the presence of R. equi. A diagnosis of purulent meningitis caused by R. equi was made.
The patient was treated with intravenous meropenem (1000 mg every 8 hours) for 19 days; then he was discharged and instructed to continue the intravenous meropenem for two weeks. After a follow-up period of 2 months, the patient had recovered completely.
After a follow-up period of 2 months, the patient had recovered completely.
Central nervous system infection caused by R. equi is rare. Early bacterial culture of CSF is important for timely diagnosis. With sufficient antibiotic therapy, the prognosis can be favorable.
Aims/Introduction
The triglyceride‐glucose (TyG) index is a simple and reliable indicator of insulin resistance, and is associated with the development and poor outcomes of cardiovascular disease. ...Subclinical left ventricular dysfunction (SLVD) is frequently detected in approximately one‐third of diabetes patients, but it has not been established whether the TyG index correlates with SLVD. We carried out this research to evaluate the relationship between the TyG index and SLVD in type 2 diabetes mellitus patients.
Materials and Methods
This was a cross‐sectional and observational study of 183 type 2 diabetes mellitus inpatients at Nanjing Drum Tower Hospital, Nanjing, China. The TyG index and homeostasis model assessment 2 estimates for insulin resistance (HOMA2‐IR) were calculated from biochemical measurements, and speckle‐tracking echocardiography was carried out. According to global longitudinal strain (GLS) by echocardiography, participants were categorized into the SLVD (GLS <18%) group or the non‐SLVD (GLS ≥18%) group.
Results
In comparison with non‐SLVD participants, SLVD participants had higher insulin resistance, as reflected by elevated TyG and HOMA2‐IR indices, as well as a higher body mass index, waist circumference and triglyceride level (P < 0.05 for each). When grouped by TyG index tertiles, an elevated TyG index was correlated with other cardiometabolic risk factors, as well as a decrease in GLS. In the multivariate logistic regression analyses, the TyG index was an independent risk factor for SLVD in type 2 diabetes mellitus patients (odds ratio 2.047, 95% confidence interval 1.07–3.914, P = 0.03), whereas HOMA2‐IR was not.
Conclusions
The TyG index is independently associated with SLVD in type 2 diabetes mellitus patients and is a more reliable indicator of SLVD than HOMA2‐IR.
Subclinical left ventricular dysfunction is frequently observed in one‐third of type 2 diabetes mellitus patients. Early detection of subclinical left ventricular dysfunction could help reverse the epidemic of cardiovascular disease in diabetes patients. As a reliable index for insulin resistance, the triglyceride‐glucose index has gradually been shown to be associated with cardiovascular disease development and poor outcomes. In the present study, we investigate the association between the triglyceride‐glucose index and subclinical left ventricular dysfunction in type 2 diabetes mellitus patients.
Two trials were performed to evaluate the association of hypothalamic abundances of thermosensitive transient receptor potential (TRP) ion channels with thermoregulation in broiler chickens. In trial ...1, temporal changes in body temperatures, and hypothalamic expression patterns of TRP channels and thermoregulatory neurotransmitter concentrations were assessed from 3 to 42 d of age. In trial 2, the same variables were compared at 2 age stages between 2 distinct types of birds with high or low rectal temperatures (HRT or LRT). The core-to-brain temperature difference exhibited a rapid increase after hatching, arriving at a steady state in the fourth week (P < 0.01). The hypothalamus saw a progressive decrease of TRPV4 protein expression through 28 d (P < 0.01), followed by a great increase in the abundance of other channels right up to the end (P < 0.05). Compared to LRT birds, a decline in hypothalamic content of TRPV4 (P < 0.05), together with a bigger core-to-brain temperature difference (P < 0.01), was evident in the HRT counterpart at 33 d. In both trials, the core-to-brain and core-to-surface temperature differences were controlled in a synchronous and coordinated manner. These results allow concluding that developmental changes in the thermal sensitivity of hypothalamic neurons, determined by brain cooling capacity, involve a neuro-genomic mechanism, which regulates the ratio between thermosensitive TRP ion channels to attain a lower proportion of TRPV4 in comparison with other channels.
Background
Dynamic artificial intelligence (AI) ultrasound intelligent auxiliary diagnosis system (Dynamic AI) is a joint application of AI technology and medical imaging data, which can perform a ...real-time synchronous dynamic analysis of nodules. The aim of this study is to investigate the value of dynamic AI in differentiating benign and malignant thyroid nodules and its guiding significance for treatment strategies.
Methods
The data of 607 patients with 1007 thyroid nodules who underwent surgical treatment were reviewed and analyzed, retrospectively. Dynamic AI was used to differentiate benign and malignant nodules. The diagnostic efficacy of dynamic AI was evaluated by comparing the results of dynamic AI examination, preoperative fine needle aspiration cytology (FNAC) and postoperative pathology of nodules with different sizes and properties in patients of different sexes and ages.
Results
The sensitivity, specificity and accuracy of dynamic AI in the diagnosis of thyroid nodules were 92.21%, 83.20% and 89.97%, respectively, which were highly consistent with the postoperative pathological results (kappa = 0.737,
p
< 0.001). There is no statistical difference in accuracy between people with different ages and sexes and nodules of different sizes, which showed the good stability. The accuracy of dynamic AI in malignant nodules (92.21%) was significantly higher than that in benign nodules (83.20%) (
p
< 0.001). The specificity and positive predictive value were significantly higher, and the misdiagnosis rate was significantly lower in dynamic AI than that of preoperative ultrasound ACR TI-RADS (
p
< 0.001). The accuracy of dynamic AI in nodules with diameter ≤ 0.50 cm was significantly higher than that of preoperative ultrasound (
p
= 0.044). Compared with FNAC, the sensitivity (96.58%) and accuracy (94.06%) of dynamic AI were similar.
Conclusions
The dynamic AI examination has high diagnostic value for benign and malignant thyroid nodules, which can effectively assist surgeons in formulating scientific and reasonable individualized diagnosis and treatment strategies for patients.
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