The checkmark association between gamma glutamyl-transpeptidase and body mass index in a large Chinese population.

BACKGROUND: Obesity has long been regarded as a risk factor for abnormal liver function, although the quantitative relationship between them is not clear. This study aimed to investigate the relationship between body mass index (BMI) and gamma-glutamyl transpeptidase (GGT) in different gender populations. METHODS: The cross-sectional study included 221,934 people aged over 18 years and under 90 years who underwent physical examinations at Yijishan Hospital in Wuhu City from 2011 to 2016. t-test and Chi-square test were used to compare the differences in demographic characteristics and biochemical indexes between men and women. Linear regression model and smooth curve method were used to investigate the relationship between BMI and GGT. RESULTS: The smooth curve shows a checkmark association between GGT and BMI. After adjusting for confounders, the cut-off BMI for the whole population was 19.5 kg/m2. When BMI was less than 19.5 kg/m2, GGT levels decreased with increasing BMI, and when BMI was greater than 19.5 kg/m2, GGT levels increased with increasing BMI. After gender stratification, there was a checkmark association between male and female GGT levels and BMI, but the trend of male GGT levels changing with BMI was more obvious than that of females. CONCLUSIONS: Our investigation demonstrated that the GGT level in obese Chinese people is significantly higher than that in non-obese people living in Wuhu City. BMI level can be considered as an early warning index for diseases related to liver function injury in the clinic, although the influence of gender difference should be specifically considered.

Dyslipidemia and hyperuricemia: a cross-sectional study of residents in Wuhu, China.

BACKGROUND: While dyslipidemia has been recognized as a potential risk factor for hyperuricemia, there is currently a dearth of large-scale data specifically focused on studying the relationship between these two conditions. To address this gap, the present study analyzed a dataset of 298,891 physical examination records to investigate in greater detail the clinical classification and compositional relationship between hyperuricemia and dyslipidemia. METHODS: For this investigation, a cross-sectional research design was utilized to analyze physical examination data that was gathered from Yijishan Hospital in Wuhu, China between 2011 and 2016. Logistic regression was employed to examine the association between hyperuricemia and dyslipidemia. Furthermore, the association between hyperuricemia and dyslipidemia was evaluated based on the clinical classifications of dyslipidemia and its components. RESULTS: A total of 298,891 participants from China (124,886 [41.8%] females) were included in the study, with an age range of 18 to 90 years (mean [SD]: 47.76 [13.54] years). In multivariate analysis, the odds of hyperuricemia was 1.878 times higher in patients with dyslipidemia compared to those without dyslipidemia (95% confidence interval [CI]: 1.835-1.922). In the clinical classification of dyslipidemia, individuals with hypertriglyceridemia and mixed hyperlipidemia had 1.753 times (95% CI: 1.706-1.802) and 1.925 times (95% CI: 1.870-1.982) higher odds of hyperuricemia, respectively, compared to those without dyslipidemia. Among the components of dyslipidemia, the odds ratios for hyperuricemia in individuals in the fourth quartile compared to those in the first quartile were 3.744 (95% CI: 3.636-3.918) for triglycerides, 1.518 (95% CI: 1.471-1.565) for total cholesterol, and 1.775 (95% CI: 1.718 - 1.833) for non-high-density lipoprotein cholesterol. CONCLUSIONS: Dyslipidemia has been independently linked with hyperuricemia. Moreover, the elevation of triglycerides or total cholesterol levels, including conditions such as hypertriglyceridemia and mixed hyperlipidemia, have been observed to have a positive association with the development of hyperuricemia.

Gender-based relationship between serum creatinine and carotid plaque stability: A cross-sectional study in China.

OBJECTIVE: Carotid plaque instability is a risk factor for ischemic stroke, and changes in serum creatinine are associated with carotid plaque. However, the relationship between serum creatinine and carotid plaque stability is not well explained. This study aimed to interpret this relationship for clinical treatment of carotid plaque. METHODS: A total of 4363 subjects aged 29-86 from December 2013 to December 2018 were included in this study. The stability of carotid plaque was determined based on ultrasound echoes and divided into two groups: carotid plaque stable group and carotid plaque unstable group. The relationship between serum creatinine and carotid plaque stability was determined using curve fitting methods as well as logistic regression. RESULTS: After age stratification, there was an inverted U-shaped curve between the stability of right carotid plaque and serum creatinine in males, When serum creatinine levels were less than 84 µmol/L, the probability of carotid plaque instability gradually increased, and the carotid plaque became stable when creatinine levels were greater than 84 µmol/L. The relationship between left carotid female plaque stability and serum creatinine showed a U-shaped curve. When serum creatinine levels were less than 80 µmol/L, the carotid plaque stability stabilized, and the probability increased when creatitine levels were more than 80 µmol/L, as the carotid plaque instability rose. CONCLUSION: There was an inverted U-shaped relationship between the stability of carotid plaque in the right carotid artery and serum creatinine in males, and a U-shaped relationship between the stability of carotid plaque in the left carotid artery and serum creatinine in females.

The V-shaped curve relationship between fasting plasma glucose and human serum albumin in a large health checkup population in China.

BACKGROUND: This study aimed to investigate the relationship between fasting plasma glucose (FPG) and human serum albumin (HSA) in a large health checkup population in China. METHODS: In this cross-sectional health checkup study, we enrolled a population of 284,635 subjects from Wuhu between 2011 and 2016. All participants completed the physical examination, blood biochemical examination, and blood routine examination. RESULTS: The prevalence of diabetes in men and women was 6.11% and 2.98%, respectively. The average level of HSA and FPG was significantly higher in men than in women (48.44 ± 3.25 vs. 47.14 ± 3.22, P < 0.0001; 5.50 ± 1.26 vs. 5.26 ± 0.94, P < 0.0001). There were significant differences in blood biochemistry and blood routine values by gender. After adjusting for confounding factors, the results showed that FPG and HSA were a V-shaped curve, and the threshold value of HSA was 40.7 mmol/L. FPG and HSA still showed a V-shaped curve after stratification by gender and age. In the male group, FPG decreased with HSA when HSA<42.3 mmol/L, and increased when HSA ≥ 42.3 mmol/L. In the female group, FPG decreased with HSA when HSA<35.7 mmol/L, and increased when HSA ≥ 35.7 mmol/L. In the age<65 group, FPG decreased with HSA when HSA<37.5 mmol/L, and increased when HSA ≥ 37.5 mmol/L. In the age ≥ 65 group, FPG decreased with HSA when HSA<43.2 mmol/L, and increased when HSA ≥ 43.2 mmol/L. CONCLUSIONS: A V-shape relationship exists between fasting plasma glucose and human serum albumin among the Chinese health checkup population studied.

A Clinical Analysis and Literature Review of Six Cases with Primary Pulmonary Lymphoepithelioma-Like Carcinoma.

Methods: The clinical data of six patients with primary pulmonary lymphoepithelioma-like carcinoma treated in Zhejiang Taizhou Hospital of Taizhou Enze Medical Center (Group) from May 2014 to December 2018 were summarized and analyzed. Combined with the relevant literature, the primary pulmonary lymphoepithelioma-like carcinoma was analyzed retrospectively. Results: The main manifestations of six patients were respiratory symptoms, and cough was the most common. The imaging features of six patients were mainly round-like high-density mass shadow or nodule shadow. All patients were diagnosed by pathology. Microscopically, the cancer cells were nested, with large nuclei and vacuoles and abundant lymphocyte infiltration in the tumor stroma. The positive rates of EBER, p63, CK5/6, and Ki-67 were high, and TTF-1 was negative. Five patients received surgical treatment. One patient developed brain metastasis 12 months after operation and received craniocerebral radiotherapy. The other patients did not receive radiotherapy and chemotherapy, and one patient did not receive treatment. After follow-up, four patients survived so far, the longest survival time was 82 months, one patient lost follow-up, and one patient died of lung metastasis 24 months after operation. Conclusion: Primary pulmonary lymphoepitheliomatoid-like carcinoma is a rare lung malignant tumor, whose pathogenesis is related to Epstein-Barr virus infection. The clinical manifestations are nonspecific, but with unique pathological characteristics. Surgical resection is the proper treatment for early-stage patients, and comprehensive treatment with surgery as the main treatment is suitable for late-stage patients. The prognosis is good.

Dynamic Changes in Lung Function and Imaging in Patients with COVID-19.

Purpose: To investigate the recovery of lung function and chest imaging in patients with COVID-19 three months after clinical cure and discharge and the correlation between them. Methods: This study collected 80 patients diagnosed with 2019-nCoV infection who were discharged from the Taizhou Public Health Medical Center in Zhejiang Province between January 31, 2020, and March 10, 2020. Lung function examinations and lung CT scans were performed at discharge and three months after discharge. The dynamic changes examined at discharge and three months after discharge were observed, and their correlation was analyzed. All data collection ended on June 25, 2020. Results: Among the 80 COVID-19 patients discharged from the hospital, the rate of abnormality indicated by lung CT images was 97.5%, mainly presenting as patchy shadows (95%), ground-glass shadows (75%), grid-like lesions, interlobular septal thickening or fiber strip shadows (30%), consolidation shadows, and nodules (10 cases each). At discharge, 72 patients (90%) had pulmonary dysfunction, 64 (80%) had restrictive ventilatory dysfunction, and 48 (60%) had small airway dysfunction. Three months after discharge, the rate of abnormality indicated by lung CT images was 12.5%. Eight cases (10%) showed residual patchy shadows, but the density was weak, and the scope was reduced. Two cases (2.5%) showed nodular shadows. Three months after discharge, 18 patients (22.5%) had residual restrictive ventilatory dysfunction, 28 patients (35%) had small airway dysfunction, and 32 patients (40%) had diffuse dysfunction. Moreover, patients with more severe chest imaging manifestations (bilateral lesions and ground-glass shadows combined with interstitial lesions) also had more obvious lung function impairment. Conclusion: Three months after being clinically cured, patients with COVID-19 had good chest imaging absorption and no residual fibrosis. Some patients had mild to moderate pulmonary dysfunction, mainly restricted ventilation dysfunction, small airway dysfunction, and diffuse dysfunction.

The Investigation of Pulmonary Function Changes of COVID-19 Patients in Three Months.

Background: Novel coronavirus disease 2019 (COVID-19) was discovered in December 2019 and has infected more than 80 million people worldwide, and more than 50 million people have achieved a clinical cure. In this study, the pulmonary function results of patients after clinical medicine for three months were reported. Objective: To investigate the effect of COVID-19 on lung function in patients. Methods: A retrospective analysis was performed on 56 COVID-19-infected patients who were cured after the clinical treatment at Taizhou Public Health Medical Center in Zhejiang Province from January 31, 2020, to March 10, 2020. At discharge and three months after discharge, lung function was measured, including inspiratory vital capacity (IVC), forced vital capacity (FVC), forced expiratory volume in first second (FEV1), forced expiratory volume in first second to inspiratory vital capacity (FEV1/IVC), maximum mid-expiratory flow rate (MEF), peak expiratory flow rate (PEF), and carbon monoxide dispersion (DLCO). Results: At discharge, there were 37 patients (66.1%) with pulmonary dysfunction, 22 patients (39.3%) with ventilation dysfunction, 31 cases (55.4%) with small airway dysfunction, and 16 cases (28.6%) with restricted ventilation dysfunction combined with small airway dysfunction. At 3 months after discharge, 24 of the 56 patients still had pulmonary dysfunction and all of them had small airway dysfunction, of which 10 patients (17.9%) were restricted ventilation dysfunction combined with small airway dysfunction. DLCO was measured three months after discharge. Twenty-nine patients (51.8%) had mild to moderate diffuse dysfunction. All pulmonary function indexes of 56 patients recovered gradually after 3 months after release, except FEV1/IVC, and the difference was statistically significant (P < 0.05). There were 41 patients of normal type (73.2%) and 15 patients of severe type (26.8%). Among the 15 severe patients, 8 patients (53.3%) had ventilation dysfunction at discharge, 9 patients (60%) had small airway dysfunction, 4 patients (26.7%) still had ventilation dysfunction 3 months after discharge, 7 patients (46.7%) had small airway dysfunction, and 10 patients (66.7%) had diffuse dysfunction. Among the 41 common type patients, 14 patients (34.1%) had ventilation dysfunction at discharge, 22 patients (53.7%) had small airway dysfunction, 6 patients (14.6%) still had ventilation dysfunction 3 months after discharge, 17 patients (41.5%) had small airway dysfunction, and 19 patients (46.3%) had diffuse dysfunction. Patients with severe COVID-19 had more pulmonary impairment and improved pulmonary function than normal patients. Conclusion: COVID-19 infection can cause lung function impairment, manifested as restricted ventilation dysfunction, small airway dysfunction, and diffuse dysfunction. The pulmonary function of most patients was improved 3 months after clinical cure and discharge, and some patients remained with mild to moderate diffuse dysfunction and small airway dysfunction.

Laboratory indicators in COVID-19 and other pneumonias: Analysis for differential diagnosis and comparison of dynamic changes during 400-day follow-up.

BACKGROUND: COVID-19 is spreading rapidly all over the world, the patients' symptoms can be easily confused with other pneumonia types. Therefore, it is valuable to seek a laboratory differential diagnostic protocol of COVID-19 and other pneumonia types on admission, and to compare the dynamic changes in laboratory indicators during follow-up. METHODS: A total of 143 COVID-19, 143 bacterial pneumonia and 145 conventional viral pneumonia patients were included. The model group consisted of 140 COVID-19, 80 bacterial pneumonia and 60 conventional viral pneumonia patients, who were age and sex matched. We established a differential diagnostic model based on the laboratory results of the model group on admission via a nomogram, which was validated in an external validation group. We also compared the 400-day dynamic changes of the laboratory indicators among groups. RESULTS: LASSO regression and multivariate logistic regression showed that eosinophils (Eos), total protein (TP), prealbumin (PA), potassium (K), high-density lipoprotein cholesterol (HDLC), and low-density lipoprotein cholesterol (LDLC) could differentiate COVID-19 from other pneumonia types. The C-index of the nomogram model was 0.922. Applying the nomogram to the external validation group showed an area under the curve (AUC) of 0.902. The 400-day change trends of the laboratory indexes varied among subgroups divided by sex, age, oxygenation index (OI), and pathogen. CONCLUSION: The laboratory model was highly accurate at providing a new method to identify COVID-19 in pneumonia patients. The 400-day dynamic changes in laboratory indicators revealed that the recovery time of COVID-19 patients was not longer than that of other pneumonia types.

A Family Segregating Lethal Primary Coenzyme Q10 Deficiency Due to Two Novel COQ6 Variants.

Primary coenzyme Q10 deficiency-6 (COQ10D6), as a rare autosomal recessive disease caused by COQ6 mutations, is characterized by progressive infantile-onset nephrotic syndrome resulting in end-stage renal failure and sensorineural hearing loss. Here, we report two Chinese siblings with COQ10D6 who primarily presented with severe metabolic acidosis, proteinuria, hypoalbuminemia, growth retardation, and muscle hypotonia and died in early infancy. Using whole-exome sequencing and Sanger sequencing, we identified two rare recessive nonsense mutations in the COQ6 gene segregating with disease in affected family members: c.249C > G (p.Tyr83Ter) and c.1381C > T (p.Gln461Ter), resulting in two truncated protein products. Both mutations are located in a highly conserved area and are predicted to be pathogenic. Indeed, the death of our patients in early infancy indicates the pathogenicity of the p.Tyr83Ter and p.Gln461Ter variants and highlights the significance of the two variants for COQ6 enzyme function, which is necessary for the biosynthesis of coenzyme Q10. In conclusion, we discovered a novel compound heterozygous pathogenic variant of the COQ6 gene as a cause of severe COQ10D6 in the two siblings. Based on the clinical history and genetic characteristics of the patients, our cases expand the genotypic spectrum of COQ10D6 and highlight the heterogeneity and severity of clinical features associated with COQ6 mutations. For patients with clinical manifestations suggestive of COQ10D6, early testing for COQ6 mutations is beneficial for disease diagnosis and therapeutic interventions as well as disease prevention in future generations.

A Panoramic Localizer Based on Coarse-to-Fine Descriptors for Navigation Assistance.

Visual Place Recognition (VPR) addresses visual instance retrieval tasks against discrepant scenes and gives precise localization. During a traverse, the captured images (query images) would be traced back to the already existing positions in the database images, rendering vehicles or pedestrian navigation devices distinguish ambient environments. Unfortunately, diverse appearance variations can bring about huge challenges for VPR, such as illumination changing, viewpoint varying, seasonal cycling, disparate traverses (forward and backward), and so on. In addition, the majority of current VPR algorithms are designed for forward-facing images, which can only provide with narrow Field of View (FoV) and come with severe viewpoint influences. In this paper, we propose a panoramic localizer, which is based on coarse-to-fine descriptors, leveraging panoramas for omnidirectional perception and sufficient FoV up to 360∘. We adopt NetVLAD descriptors in the coarse matching in a panorama-to-panorama way, for their robust performances in distinguishing different appearances, utilizing Geodesc keypoint descriptors in the fine stage in the meantime, for their capacity of detecting detailed information, formatting powerful coarse-to-fine descriptors. A comprehensive set of experiments is conducted on several datasets including both public benchmarks and our real-world campus scenes. Our system is proved to be with high recall and strong generalization capacity across various appearances. The proposed panoramic localizer can be integrated into mobile navigation devices, available for a variety of localization application scenarios.

A method of elevated temperatures coupled with magnetic stirring to predict real time release from long acting progesterone PLGA microspheres.

The object of the study was to develop a quick and reproducible accelerated in vitro release method to predict and deduce the function of the real time (37 °C) release for long acting PLGA microspheres. The method could be described in several steps. First, the release of the microspheres were studied using the sample and separate method at 37 °C with normal orbital shaking and elevated temperatures with magnetic stirring to further accelerate the release. Second, the most similar profile at elevated temperatures with the real time release was chosen with the help of the n value in the fitted Korsmeyer-Peppas Function. Third, the Weibull function and conversion ratio were used to deduce the function of real time release according to the chosen profile at elevated temperatures. The key point in this study was to provide a quick and precise method to predict the real time release for long acting progesterone PLGA microspheres. So the elevated temperatures coupled with magnetic stirring were used to accelerate the release further, and when there have many similar release profiles with the real time release at elevated temperatures, releasing time at elevated temperatures and the R2 of the final deduced function will be used to help choosing the most similar release profile with the real time release. Four different types of progesterone PLGA microspheres were used to verify the method, and all the deduced function correlated well with the real time releases, for R 2  = 0.9912, 0.9781, 0.9918 and 0.9972, respectively.

Advanced easySTED microscopy based on two-photon excitation by electrical modulations of light pulse wavefronts.

We developed a compact stimulated emission depletion (STED) two-photon excitation microscopy that utilized electrically controllable components. Transmissive liquid crystal devices inserted directly in front of the objective lens converted the STED light into an optical vortex while leaving the excitation light unaffected. Light pulses of two different colors, 1.06 and 0.64 µm, were generated by laser diode-based light sources, and the delay between the two pulses was flexibly controlled so as to maximize the fluorescence suppression ratio. In our experiments, the spatial resolution of this system was up to three times higher than that obtained without STED light irradiation, and we successfully visualize the fine microtubule network structures in fixed mammalian cells without causing significant photo-damage.

1 MW peak-power subpicosecond optical pulse source based on a gain-switched laser diode.

We have generated optical pulses of 1.2 MW peak power and 0.6 ps duration using a 1060 nm band gain-switched laser diode pulse oscillator. Optical pulses are amplified by three-stage ytterbium-doped fiber amplifiers, and remarkable reductions of amplified spontaneous emission noise and temporal duration have been accomplished based on self-phase modulation in the middle-stage amplifier. After the main amplifier, optical pulses were temporally compressed by a grating pair, and this enabled generation of subpicosecond optical pulses with over 1 MW peak power.

Generation of synchronized picosecond pulses by a 1.06-µm gain-switched laser diode for stimulated Raman scattering microscopy.

We propose that a gain-switched laser diode (GS-LD) can be used as a picosecond laser source for stimulated Raman scattering (SRS) microscopy. We employed a 1.06-µm GS-LD to generate ~13-ps pulses at a repetition rate of 38 MHz and amplified them to >100 mW with Yb-doped fiber amplifiers. The GS-LD was driven by 200-ps electrical pulses, which were triggered through a toggle flip-flop (T-FF) so that the GS-LD pulses were synchronized to Ti:sapphire laser (TSL) pulses at a repetition rate of 76 MHz. We found the timing jitter of GS-LD pulses to be approximately 2.7 ps in a jitter bandwidth of 7 MHz. We also show that the delay of electrical pulses can be less sensitive to the optical power of TSL pulses by controlling the threshold voltage of the T-FF. We demonstrate the SRS imaging of polymer beads and of HeLa cells with GS-LD pulses and TSL pulses, proving that GS-LD is readily applicable to SRS microscopy as a compact and stable pulse source.

In vivo two-photon imaging of mouse hippocampal neurons in dentate gyrus using a light source based on a high-peak power gain-switched laser diode.

In vivo two-photon microscopy is an advantageous technique for observing the mouse brain at high resolution. In this study, we developed a two-photon microscopy method that uses a 1064-nm gain-switched laser diode-based light source with average power above 4 W, pulse width of 7.5-picosecond, repetition rate of 10-MHz, and a high-sensitivity photomultiplier tube. Using this newly developed two-photon microscope for in vivo imaging, we were able to successfully image hippocampal neurons in the dentate gyrus and obtain panoramic views of CA1 pyramidal neurons and cerebral cortex, regardless of age of the mouse. Fine dendrites in hippocampal CA1 could be imaged with a high peak-signal-to-background ratio that could not be achieved by titanium sapphire laser excitation. Finally, our system achieved multicolor imaging with neurons and blood vessels in the hippocampal region in vivo. These results indicate that our two-photon microscopy system is suitable for investigations of various neural functions, including the morphological changes undergone by neurons during physiological phenomena.