Systematic Analysis Identifies a Specific RNA-Binding Protein-Related Gene Model for Prognostication and Risk-Adjustment in HBV-Related Hepatocellular Carcinoma.

OBJECTIVE: Increasing evidence shows that dysregulated RNA binding proteins (RBPs) modulate the progression of several malignancies. Nevertheless, their clinical implications of RBPs in HBV-related hepatocellular carcinoma (HCC) remain largely undefined. Here, this study systematically analyzed the associations of RBPs with HBV-related HCC prognosis. METHODS: Based on differentially expressed RBPs between HBV-related HCC and control specimens, prognosis-related RBPs were screened by univariate analyses. A LASSO model was then created. Kaplan-Meier curves, ROCs, multivariate analyses, subgroup analyses and external verification were separately applied to assess the efficacy of this model in predicting prognosis and recurrence of patients. A nomogram was created by incorporating the model and clinical indicators, which was verified by ROCs, calibration curves and decision curve analyses. By CIBERSORT algorithm, the association between the risk score and immune cell infiltrations was evaluated. RESULTS: Totally, 54 RBPs were distinctly correlated to prognosis of HBV-related HCC. An 11-RBP model was created, containing POLR2L, MRPS12, DYNLL1, ZFP36, PPIH, RARS, SRP14, DDX41, EIF2B4, and NOL12. This risk score sensitively and accurately predicted one-, three- and five-year overall survival, disease-free survival, and progression-free interval. Compared to other clinical parameters, this risk score had the best predictive efficacy. Also, the clinical generalizability of the model was externally verified in the GSE14520 dataset. The nomogram may predict patients' survival probabilities. Also, the risk score was related to the components in the immune microenvironment. CONCLUSION: Collectively, RBPs may act as critical elements in the malignant progression of HBV-related HCC and possess potential implications on prognostication and therapy decision.

The safety and feasibility of the screening for retinopathy of prematurity assisted by telemedicine network during COVID-19 pandemic in Wuhan, China.

BACKGROUND: During the coronavirus disease 2019 (COVID-19) epidemic, due to the traffic blockade and the shortage of medical resources, more and more premature infants could not receive timely and effective ROP screening, which delayed treatment and even caused children blindness. Therefore, how to carry out ROP screening safely and effectively during the epidemic was very important and urgent. This study aimed to evaluate the safety and feasibility of ROP screening assisted by telemedicine network during COVID-19 outbreak. METHODS: This retrospective study was conducted at Wuhan Children's hospital in Wuhan, China, from January to October, 2020. The measures which were performed to make the ROP screening more safe and effective were summarized and the comparison between ROP screening assisted by telemedicine network in 2020 and usual screening in 2019 were analyzed. RESULTS: A total of 267 outpatient infants completed ROP screening. The median gestational age was 32 weeks (30w to 34w) and the median birth weight was 1780 g (1460 g to 2100 g). Meanwhile, 149 (55.8%) out of 267 infants were males. During January to May in 2020, 86 screening appointments were received, among which 67 (77.9%) were from telemedicine platform online. The completing percentage of total online ROP appointments was higher than that of total face-to-face appointments (58.1% VS 22. 1%, P = 0.018). As for the number of infants screened between 2020 and 2019 from Februaryto October, 54 infants completed ROP screening in 2020, which was higher than that (51participants) in 2019 on September. Furthermore, compared with the usual screening in 2019, ROP screening assisted by telemedicine network in 2020 had smaller gestational age (32w VS 33w, p<0.001) and lower birth weight (1780 g VS 1900 g, p = 0.001). However, of the 267 infants screened, 18(6.7%) had ROP while the percentage of ROP screened in 2019 was the same (44[6.7%]). During follow-up, none of medical staffs was infected and no adverse reaction was reported. CONCLUSIONS: The screening for retinopathy of prematurity assisted by telemedicine network was safe and feasible during the COVID-19 pandemic. Preventive measures before and after screening were very necessary, which could effectively avoid cross infection.

The Application of Tissue Glue in Eyelid Laceration Repair in Children During the Coronavirus Disease 2019 Pandemic Lockdown in Wuhan.

OBJECTIVE: To discuss a rapid and effective treatment used for children with eyelid lacerations during the COVID-19 lockdown in Wuhan to limit the risk of cross-infection. METHODS: A comparative study was conducted of forty-five patients with eyelid lacerations who attended the Ophthalmology Department of Wuhan Children's Hospital between January 23, 2020 and March 6, 2020. The tissue glue Histoacryl was used to bond the wounds in 24 cases, while the traditional suture method was used for 21 cases. The wound healing time, complications, treatment satisfaction, and number of visits of the two groups were compared. RESULTS: The two groups had similar baseline characteristics. The wound healing time (from wound disinfection to wound dressing) was shorter in the tissue glue group (4.35 ± 0.47min versus 11.71 ± 1.85 min, P< 0.01). There was 1 case of wound dehiscence in the tissue glue group. Twenty-two cases in the tissue glue group were satisfied, 2 cases were basically satisfied, and 0 were dissatisfied. Eleven cases in the traditional suture group were satisfied, 9 cases were basically satisfied, and 1 case was dissatisfied. The difference was statistically significant (P < 0.05). In terms of the number of visits, the tissue glue group visited (1.54 ± 0.88) times, while the traditional suture group visited (2.38 ± 0.59) times. The difference between the two groups was statistically significant (P < 0.01). The real-time reverse transcriptase polymerase chain tests for severe acute respiratory syndrome coronavirus 2 of all medical staff in the ophthalmology emergency room were negative. CONCLUSION: Compared with the traditional suture method, tissue glue used in eyelid laceration in children has the advantages of painlessness, shorter operation duration, higher safety and satisfaction, greater ease of care, and fewer hospital visits. Tissue glue can be widely used to reduce the risk of cross-infection.

Clinical implications of serum hepatitis B virus RNA quantitation in untreated chronic hepatitis B virus-infected patients.

Serum hepatitis B virus (HBV) RNA quantitation may be useful for managing untreated chronic HBV-infected patients, but its distribution characteristics and relationship to HBV DNA are unclear. A retrospective cohort including 149 untreated HBV-infected patients was divided into four clinical phenotypes: hepatitis B envelope antigen (HBeAg) positive with normal alanine transaminase (ALT; EPNA) or with elevated ALT (EPEA), HBeAg-negative with normal ALT (ENNA) or with elevated ALT (ENEA). Serum HBV RNA levels were quantified by a high-sensitivity real-time fluorescent quantitative PCR method and liver biopsy was performed in those with undetectable serum HBV DNA or RNA. The detectable serum HBV RNA levels (log10 copies/mL) in EPNA, EPEA, ENNA, and ENEA were 6.02±1.48, 6.54±1.27, 2.51±0.78 and 3.54±1.25, respectively. The low level (< 2.0 log10 copies/mL) comprised mainly of ENNA phenotype (76.9%), while the high level (> 6.0 log10 copies/mL) was HBeAg-positive patients (98.1%). Serum HBV RNA level were significantly correlated with serum HBV DNA and HBsAg in HBeAg-positive phenotypes, but a correlation only with HBV DNA was observed in ENEA patients. Serum HBV DNA and RNA were both independent risk factors associated with elevated ALT in HBeAg-negative patients. Seven serum HBV DNA-undetectable but RNA-detectable patients underwent liver biopsy, showing moderate or severe liver inflammation. Varying serum HBV RNA levels can reflect natural disease phases in untreated HBV-infected patients, indicating that this biomarker could reflect liver inflammation in untreated HBeAg-negative patients as successfully as serum HBV DNA. Serum HBV RNA can complement clinical management strategies when serum HBV DNA is undetectable.

Ocular Manifestations and Clinical Characteristics of Children With Laboratory-Confirmed COVID-19 in Wuhan, China.

Importance: Ocular manifestations and outcomes in children with confirmed coronavirus disease 2019 (COVID-19), relevant affecting factors, and differences in ocular disease between children and adults have yet to be fully understood. Objective: To investigate ocular manifestations and clinical characteristics of children with laboratory-confirmed COVID-19. Design, Setting, and Participants: This cross-sectional study was conducted at Wuhan Children's Hospital in Wuhan, China. Children with COVID-19 confirmed by severe acute respiratory syndrome coronavirus disease 2 nucleic acid tests of upper respiratory tract specimens between January 26 and March 18, 2020, were included. Main Outcomes and Measures: Onset clinical symptoms and duration, ocular symptoms, and needs for medication. Results: A total of 216 pediatric patients were included, among whom 134 (62%) were boys, with a median (interquartile range) age of 7.25 (2.6-11.6) years. Based on the exposure history, 193 children (89.4%) had a confirmed (173 [80.1%]) or suspected (20 [9.3%]) family member with COVID-19 infection. The most common symptoms among symptomatic children were fever (81 [37.5%]) and cough (79 [36.6%]). Of 216 children, 93 (43.1%) had no systemic or respiratory symptoms. All children with mild (101 [46.8%]) or moderate (115 [53.2%]) symptoms recovered without reported death. Forty-nine children (22.7%) showed various ocular manifestations, of which 9 had ocular complaints being the initial manifestations of COVID-19. The common ocular manifestations were conjunctival discharge (27 [55.1%]), eye rubbing (19 [38.8%]), and conjunctival congestion (5 [10.2%]). Children with systemic symptoms (29.3% vs 14.0%; difference, 15.3%; 95% CI, 9.8%-20.7%; P = .008) or with cough (31.6% vs 17.5%; difference, 14.1%; 95% CI, 8.0%-20.3%; P = .02) were more likely to develop ocular symptoms. Ocular symptoms were typically mild, and children recovered or improved. Conclusions and Relevance: In this cross-sectional study, children hospitalized with COVID-19 in Wuhan, China, presented with a series of onset symptoms including fever, cough, and ocular manifestations, such as conjunctival discharge, eye rubbing, and conjunctival congestion. Patients' systemic clinical symptoms or cough were associated with ocular symptoms. Ocular symptoms recovered or improved eventually.

Effects of acupuncture therapy on abdominal fat and hepatic fat content in obese children: a magnetic resonance imaging and proton magnetic resonance spectroscopy study.

OBJECTIVES: The aim of this study was to use magnetic resonance imaging (MRI) together with proton magnetic resonance spectroscopy ((1)H-MRS) to study the influence of acupuncture therapy on abdominal fat and hepatic fat content in obese children. DESIGN: The design was a longitudinal, clinical intervention study of acupuncture therapy. SUBJECTS: SUBJECTS were 10 healthy, obese children (age: 11.4 ± 1.65 years, body-mass index [BMI]: 29.03 ± 4.81 kg/m(2)). MEASUREMENTS: Measurements included various anthropometric parameters, abdominal fat (assessed by MRI) and hepatic fat content (assessed by (1)H-MRS) at baseline and after 1 month of acupuncture therapy. RESULTS: One (1) month of acupuncture therapy significantly reduced the subjects' BMI by 3.5% (p = 0.005), abdominal visceral adipose tissue (VAT) volume by 16.04% (p < 0.0001), abdominal total adipose tissue volume by 10.45% (p = 0.001), and abdominal visceral to subcutaneous fat ratio by 10.59% (p = 0.007). Decreases in body weight (-2.13%), waist circumference (-1.44%), hip circumference (-0.33%), waist-to-hip ratio (WHR) (-0.99%), abdominal subcutaneous adipose tissue (SAT) volume (-5.63%), and intrahepatic triglyceride (IHTG) content (-9.03%) were also observed, although these were not significant (p > 0.05). There was a significant correlation between the level of abdominal fat (SAT, VAT) and anthropometric parameters (weight, BMI, waist circumferences, hip circumferences). There was no statistically significant correlation between IHTG and anthropometric parameters or abdominal fat content. CONCLUSIONS: The first direct experimental evidence is provided demonstrating that acupuncture therapy significantly reduces BMI and abdominal adipose tissue by reducing abdominal VAT content without significant changes in body weight, waist circumference, hip circumference, WHR, abdominal SAT, or IHTG content. Thus, the use of acupuncture therapy to selectively target a reduction in abdominal VAT content should become more important and more popular in the future.

Serum lipid profile in obese children in China.

BACKGROUND: The aim of the present study was to examine the serum lipid profile in obese Chinese children, their serum lipid and apolipoprotein A-I (apoA-I) and B (apoB) levels were examined. METHODS: The subjects were 153 patients (109 male and 44 female) aged 4-16 years with obesity, who attended the outpatient clinic of Beijing Children's Hospital. Percentage bodyweight (%BW) ([(bodyweight - standard weight)/standard weight]x 100) were obtained. Skinfold thickness and hip and waist circumference were measured. Percentage body fat (%BF) was estimated by bioelectrical impedance analyzer. Serum total cholesterol (TC), high density lipoprotein cholesterol (HDLC), triglyceride (TG), apoA-I and apoB levels were also measured. RESULTS: TC showed an acceptable level in 86.8% of obese children. The prevalence of high TC levels (3.3%) or high LDLC levels (6.0%) was rather low. The HDLC level was reduced in 31.3% of obese children. Anthropometric variables had no linear relationship to TC, HDLC, TG, LDLC, apoA-I or apoB, but in the older age group (over 10 years old) %BW and %BF showed a weak correlation with HDLC (r = -0.202, r = -0.211, respectively). CONCLUSION: In obese Chinese children, HDLC as well as TC levels should be examined in order to assess coronary risk.

Body fat ratios in urban Chinese children.

OBJECTIVE: As obesity has been increasing in China, the present study examined the body composition of children to assess their fatness. STUDY DESIGN: A total of 532 healthy schoolchildren who lived in central Beijing were examined. Skinfold thicknesses, hip and waist circumferences, and body fat percentage were measured, as well as height and weight. RESULTS: The prevalence of overweight (Body Mass Index (BMI) >or= 95% for age and sex of Chinese children) was 27.7% in boys and 14.2% in girls (chi-squared; P = 0.0001). The percentages of body fat (BF%), waist/hip ratios and skinfold thicknesses ratios (subscapular/triceps) in overweight children were significantly higher than those in non-overweight children (Mann-Whitney U-test). The BF% of non-overweight boys was significantly higher than that of non-overweight girls. CONCLUSION: Urban Chinese overweight children have high BF% with adverse fat distribution. They may have high risk of atherogeniety. Boys in the non-overweight category may have higher fat accumulation than predicted by BMI. The establishment of an intervention program for childhood obesity is strongly recommended.