Comparison of SOX and CAPOX in patients with advanced gastric cancer after laparoscopic D2 gastrectomy: A randomized controlled trial.

BACKGROUND: Optimal adjuvant chemotherapy after laparoscopic surgery in gastric cancer (GC) patients is still undefined. We aimed to evaluate the efficacy of S-1 plus oxaliplatin (SOX) and capecitabine plus oxaliplatin (CAPOX) in patients with GC after laparoscopic gastrectomy. METHODS: A non-inferiority randomized controlled clinical trial was performed in China. Patients with advanced GC who underwent laparoscopic D2 gastrectomy were randomly assigned to receive SOX and CAPOX regimens. RESULTS: In total, 191 patients were screened between May 2018 and June 2019, and 140 (73.3%) were included in the modified intent-to-treat analysis (mITT), of whom 69 and 71 were assigned to the SOX and CAPOX groups, respectively. The SOX group had similar 3-year overall survival (OS) and disease-free survival to the CAPOX group. Subgroup analysis revealed significantly better OS in the SOX group for male patients ([HR] = 0.395; 95% [CI], 0.153-1.019; p = 0.045), age >60 (HR = 0.219; 95% [CI], 0.064-0.753; p = 0.016), tumors in the gastric antrum (HR = 0.273; 95% [CI], 0.076-0.981; p = 0.047), and moderately differentiated tumors (HR = 0.338; 95% [CI], 0.110-1.041; p = 0.041). There were no significant differences observed in terms of adverse events and recurrence patterns between the two groups. CONCLUSION: Adjuvant SOX was non-inferior to CAPOX treatments for patients with GC who underwent curative laparoscopic D2 gastrectomy. For male patients, aged >60 years, tumors in the gastric antrum, and moderately differentiated tumors, adjuvant SOX may achieve an improvement compared with CAPOX.

Nf1 in heart development: a potential causative gene for congenital heart disease: a narrative review.

Congenital heart disease is the most frequent congenital disorder, affecting a significant number of live births. Gaining insights into its genetic etiology could lead to a deeper understanding of this condition. Although the Nf1 gene has been identified as a potential causative gene, its role in congenital heart disease has not been thoroughly clarified. We searched and summarized evidence from cohort-based and experimental studies on the issue of Nf1 and heart development in congenital heart diseases from various databases. Available evidence demonstrates a correlation between Nf1 and congenital heart diseases, mainly pulmonary valvar stenosis. The mechanism underlying this correlation may involve dysregulation of epithelial-mesenchymal transition (EMT). The Nf1 gene affects the EMT process via multiple pathways, including directly regulating the expression of EMT-related transcription factors and indirectly regulating the EMT process by regulating the MAPK pathway. This narrative review provides a comprehensive account of the Nf1 involvement in heart development and congenital cardiovascular diseases in terms of epidemiology and potential mechanisms. RAS signaling may contribute to congenital heart disease independently or in cooperation with other signaling pathways. Efficient management of both NF1 and cardiovascular disease patients would benefit from further research into these issues.

[Correlation between macrophage chemotaxis and disease severity in patients with knee osteoarthritis].

OBJECTIVE: To investigate the enhancement of macrophage chemotaxis in patients with knee osteoarthritis (KOA) and its correlation with the disease severity. METHODS: Eighty patients with KOA admitted from July 2019 to June 2022 were enrolled as the observation group and divided into 29 cases of moderate group, 30 cases of severe group and 21 cases of extremely severe group. At the same time, 30 healthy subjects were included as the control group. The gene expressions of NF-κB, CXC chemokine receptor 7 (CXCR7) and CXC chemokine ligand 12 (CXCL12) in macrophages of each group were analyzed. Visual analogue scale(VAS) was used to evaluate the degree of joint pain. Joint function was evaluated by knee Joint Society Scoring system(KSS). Finally, data analysis was carried out. RESULTS: The expression levels of NF-κB, CXCR7 and CXCL12 in moderate group, severe group and extreme recombination group were higher than those in control group. The VAS, the expression of NF-κB, CXCR7 and CXCL12 in the severe group and the extreme recombination group were higher than those in the moderate group, whereas KSS was lower than that in the moderate group. The VAS, expression levels of NF-κB, CXCR7 and CXCL12 in the extremely severe group were higher than those in the severe group, and KSS was lower than that in the severe group (all P<0.01). The expression levels of NF-κB, CXCR7 and CXCL12 in macrophages were positively correlated with VAS score, but negatively correlated with KSS(all P<0.01). The expression levels of NF-κB, CXCR7 and CXCL12 in macrophages were positively correlated with the severity of disease. After excluding the influence of traditional factors (gender, age and disease duration), multiple linear regression analysis further showed that the expression levels of NF-κB, CXCR7 and CXCL12 were still positively correlated with the severity of disease(all P<0.01). CONCLUSION: The chemotaxis of macrophages in patients with KOA increased with the aggravation of the disease, and was related to the degree of pain and function impairment.

Highly Conductive, Ultrastrong, and Flexible Wet-Spun PEDOT:PSS/Ionic Liquid Fibers for Wearable Electronics.

Conductive poly(3,4-ethylenedioxythiophene):poly(styrenesulfonate) (PEDOT:PSS) fibers with high electrical conductivity, flexibility, and robustness are urgently needed for constructing wearable fiber-based electronics. In this study, the highly conductive (4288 S/cm), ultrastrong (a high tensile strength of 956 MPa), and flexible (a low Young's modulus of 3.8 GPa) PEDOT:PSS/1-ethyl-3-methylimidazolium dicyanamide (EMIM:DCA) (P/ED) fiber was prepared by wet-spinning and a subsequent H2SO4-immersion-drawing process. As far as we know, this is the best performance of the PEDOT:PSS fiber reported so far. The structure and conformation of the P/ED fiber were characterized by FESEM, XPS, Raman spectroscopy, UV-vis-NIR spectroscopy, and WAXS. The results show that the high performances of the P/ED fiber are mainly attributed to the massive removal of PSS and high degree of crystallinity (87.9%) and orientation (0.71) of PEDOT caused by the synergistic effect of the ionic liquid, concentrated sulfuric acid, and high stretching. Besides, the P/ED fiber shows a small bending radius of 0.1 mm, and the conductivity of the P/ED fiber is nearly unchanged after 1000 repeated cycles of bending and humidity changes within 50-90%. Based on this, various P/ED fiber-based devices including the circuit connection wire, thermoelectric power generator, and temperature sensor were constructed, demonstrating its wide applications for constructing flexible and wearable electronics.

Research on ability of tetramethylpyrazine on promoting neurogenesis after OGD injury based on neural stem cell microenvironment / 中国药理学通报

Aim To study the ability of tetramethylpyrazine (TMP) on promoting neurogenesis in neural stem cell microenvironment after oxygen-glucose deprivation (OGD) injury in vitro. Methods Neural stem cells (NSCs), astrocytes (ACs) and cerebral microvascular endothelial cells (BMECs) were respectively extracted and separated to establish a co-culture system. The OGD modeling conditions were optimized by NSCs activity, and the concentration of TMP was optimized by Nissl staining. Then CCK-8 and Nestin

Correlation between macrophage chemotaxis and disease severity in patients with knee osteoarthritis / 中国骨伤

OBJECTIVE@#To investigate the enhancement of macrophage chemotaxis in patients with knee osteoarthritis (KOA) and its correlation with the disease severity.@*METHODS@#Eighty patients with KOA admitted from July 2019 to June 2022 were enrolled as the observation group and divided into 29 cases of moderate group, 30 cases of severe group and 21 cases of extremely severe group. At the same time, 30 healthy subjects were included as the control group. The gene expressions of NF-κB, CXC chemokine receptor 7 (CXCR7) and CXC chemokine ligand 12 (CXCL12) in macrophages of each group were analyzed. Visual analogue scale(VAS) was used to evaluate the degree of joint pain. Joint function was evaluated by knee Joint Society Scoring system(KSS). Finally, data analysis was carried out.@*RESULTS@#The expression levels of NF-κB, CXCR7 and CXCL12 in moderate group, severe group and extreme recombination group were higher than those in control group. The VAS, the expression of NF-κB, CXCR7 and CXCL12 in the severe group and the extreme recombination group were higher than those in the moderate group, whereas KSS was lower than that in the moderate group. The VAS, expression levels of NF-κB, CXCR7 and CXCL12 in the extremely severe group were higher than those in the severe group, and KSS was lower than that in the severe group (all P<0.01). The expression levels of NF-κB, CXCR7 and CXCL12 in macrophages were positively correlated with VAS score, but negatively correlated with KSS(all P<0.01). The expression levels of NF-κB, CXCR7 and CXCL12 in macrophages were positively correlated with the severity of disease. After excluding the influence of traditional factors (gender, age and disease duration), multiple linear regression analysis further showed that the expression levels of NF-κB, CXCR7 and CXCL12 were still positively correlated with the severity of disease(all P<0.01).@*CONCLUSION@#The chemotaxis of macrophages in patients with KOA increased with the aggravation of the disease, and was related to the degree of pain and function impairment.

Power of the Sine Hamiltonian Operator for Estimating the Eigenstate Energies on Quantum Computers.

Quantum computers have been shown to have tremendous potential in solving difficult problems in quantum chemistry. In this paper, we propose a new classical-quantum hybrid method, named as power of sine Hamiltonian operator (PSHO), to evaluate the eigenvalues of a given Hamiltonian (H). In PSHO, for any reference state |φ0⟩, the normalized energy of the sinn(H^τ)|φ0⟩ state can be determined. With the increase of the power, the initial reference state can converge to the eigenstate with the largest |sin(Eiτ)| value in the coefficients of the expansion of |φ0⟩, and the normalized energy of the sinn(H^τ)|φ0⟩ state converges to Ei. The ground- and excited-state energies of a Hamiltonian can be determined by taking different τ values. The performance of the PSHO method is demonstrated by numerical calculations of the H4 and LiH molecules. Compared with the current popular variational quantum eigensolver method, PSHO does not need to design the ansatz circuits and avoids the complex nonlinear optimization problems. PSHO has great application potential in near-term quantum devices.

[Clinical study of modified Yiyi Baijiang Decoction on psoriasis vulgaris due to dampness-heat accumulation].

The present study observed the clinical effect of modified Yiyi Baijiang Decoction on psoriasis vulgaris and explored its influence on growth factors and inflammatory factors in the serum and skin tissues. A total of 130 patients were randomly divided into control group and experimental group, with 65 cases in each group. The patients in the control group received Acitretin Capsules and Calcipotriol Ointment, and those in the experimental group received modified Yiyi Baijiang Decoction combined with external application for four weeks. The psoriasis area and severity index(PASI), blood vessel count in the superficial dermis(SDBVC), skin thickness(STK), and traditional Chinese medicine(TCM) symptoms were observed before and after treatment. The growth factors [epidermal growth factor(EGF), endothelial cell-specific molecule-1(ESM-1), fibroblast growth factor-23(FGF-23), and transforming growth factor-ß1(TGF-ß1)] and inflammatory factors [nuclear factor-κB(NF-κB), prealbumin(PA), CC chemokine ligand 20(CCL20), and procalcitonin(PCT)] in the serum and skin tissues were detected. The total effective rate was 98.5% in the experimental group, higher than that 83.1% in the control group(P<0.05). Compared with the control group after treatment, the experimental group showed decreased PASI, SDBVC, STK, TCM symptoms, ESM-1, FGF-23, TGF-ß1, NF-κB, CCL20, and PCT(P<0.05), and increased EGF and PA(P<0.05). The incidence of adverse events was 1.5% in the experimental group, lower than that 21.5% in the control group(P<0.05). The results showed that modified Yiyi Baijiang Decoction could effectively relieve skin lesions in patients with psoriasis vulgaris and improve the growth factors and inflammatory factors in the serum and skin lesions, with high safety.

Orthogonal State Reduction Variational Eigensolver for the Excited-State Calculations on Quantum Computers.

Variational quantum eigensolver (VQE) is a promising method for ground-state calculations on current noisy intermediate-scale quantum computers. However, the research progress of excited-state calculations on quantum computers is relatively slow. In order to extend the framework of VQE for excited-state calculations, we propose a new algorithm, orthogonal state reduction variational eigensolver (OSRVE), to determine the energies of excited states. Theoretical derivations prove that the optimized state in the OSRVE method can ensure the energy minimum and orthogonality constraint simultaneously, and OSRVE is also applicable for the degenerate state. The performance of OSRVE is demonstrated by numerical calculations of the H4 and H2O molecules. Compared with other excited-state calculation algorithms, OSRVE has obvious advantages in calculating lower-order excited states. This work extends the VQE algorithm to excited-state calculations, and OSRVE can be implemented on near-term quantum computers.

Somatostatin Treatment for Ectopic ACTH Syndrome due to Pancreatic Neuroendocrine Tumors: Review of the Literature.

Objectives: To analyze and summarize the effect of SSA treatment on EAS due to p-NETs (EAS-p-NETs). Methods: Thirteen patients with EAS-p-NETs treated with SSAs at our center or described in the literature were included in this study. Clinical characteristics, laboratory data, imaging studies, histopathologic results, the effect of SSA treatment, and the prognosis of these EAS-p-NET patients were evaluated. Results: Four males and 9 females with an average age of 42.9 years were included in the study. The mean duration of follow-up was 38.8 ± 28.2 months. As one of the combined treatment measures, SSAs controlled the levels of ACTH and cortisol in 9 of the 13 patients (69.2%). Partial response was observed in 3 patients (23.1%), stable disease in 2 patients (15.4%), and progressive disease in 6 patients (46.2%). The median time to tumor progression was 24 months, and the median overall survival was 61 months. The side effects of SSA treatment included temporary mild abdominal pain, diarrhea, gallstones, and cholecystitis. Conclusions: As a supplemental therapy, SSA treatment led to clinical and biochemical improvement with a good safety profile in patients exhibiting EAS-p-NET with metastasis. However, tumor progression was inhibited by SSA treatment in only a few patients. Combined with other treatments, SSAs may improve the prognosis of patients with EAS-p-NETs.

Comparative research on separation and purification methods of neural stem cells / 中国药理学通报

Aim To explore and optimize the different separation and purification methods of neural stem cells (NSCs) , and compare the cell viability and purity after separation and purification.Methods (X) Separation of NSCs: The brains of ICR mice born within 24 h were isolated ( the cerebellum and olfactory bulb removed) , chopped and digested by mechanical pipetting, trypsin digestion, and PDD enzyme digestion.After sieving and centrifugation, the brain tissues were inoculated at a concentration of 1 X 10 • L , and cultured in serum-free medium to observe and compare the activity, proliferation and number of miscellaneous cells.(2) Purification of NSCs: The brain tissues of mice born within 24 h were isolated, and NSCs were purified by differential centrifugation and sieving, and the purity was identi-fied by immunofluorescence.Results NSCs separated by PDD enzyme digestion had high survival rate and rapid proliferation rate; the Nestin positive rate of NSCs in both Sieving assay and Differential centrifugation assay groups was higher than that of primary NSCs (59.14% ± 0.16% , P <0.05) , and the former (93.54% ± 0.02%) was higher than the latter (86.12% ± 0.04% ) .Conclusions The three separation methods can obtain a large amount of NSCs.Among them, the PDD enzymatic digestion method has little damage to the NSCs, and the neuro-sphere proliferation speed is fast; the NSCs obtained by the sieving assay have higher purity.

Synergistically Improving Flexibility and Thermoelectric Performance of Composite Yarn by Continuous Ultrathin PEDOT:PSS/DMSO/Ionic Liquid Coating.

Combining fabrics with a poly(3,4-ethylenedioxythiophene):poly(styrenesulfonate) (PEDOT:PSS) coating is the most promising method to fabricate wearable thermoelectric (TE) devices. However, the high modulus, low strain, and low TE performance of PEDOT:PSS coating lead to poor flexibility and low power generation efficiency. In this study, dimethyl sulfoxide (DMSO) and ionic liquids (ILs) were selected as a modifier to enhance the flexibility and TE performance of PEDOT:PSS. Different from the penetrating structure and coil conformation of pristine PEDOT:PSS coating, a flexible continuous ultrathin layer of PEDOT:PSS/DMSO/1-ethyl-3-methylimidazolium dicyanamide (P/D/ED) with a linear conformation forms on the surface of cotton yarn. The morphology and structure of PEDOT:PSS and P/D/ED coating were characterized by FESEM, XPS, and Raman spectroscopy. Compared with the pristine PEDOT:PSS film, the P/D/ED film shows significantly reduced modules and enhanced strain and bending stability. Moreover, the TE performance of P/D/ED-coated yarn is significantly enhanced with nearly half mass loading. Based on this, a large-area wearable TE fabric with enhanced flexibility and TE performance was prepared. The output power density is 136.1 mW/m2 at ΔT = 40.8 K, which is a typically high value compared with the former reported composite TE fabrics. This study provides a new way to synergistically enhance the flexibility and TE performance of composite yarn, and the prepared TE fabric has great potential as a wearable power source.

Human coronaviruses and therapeutic drug discovery.

BACKGROUND: Coronaviruses (CoVs) are distributed worldwide and have various susceptible hosts; CoVs infecting humans are called human coronaviruses (HCoVs). Although HCoV-specific drugs are still lacking, many potent targets for drug discovery are being explored, and many vigorously designed clinical trials are being carried out in an orderly manner. The aim of this review was to gain a comprehensive understanding of the current status of drug development against HCoVs, particularly severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). MAIN TEXT: A scoping review was conducted by electronically searching research studies, reviews, and clinical trials in PubMed and the CNKI. Studies on HCoVs and therapeutic drug discovery published between January 2000 and October 2020 and in English or Chinese were included, and the information was summarized. Of the 3248 studies identified, 159 publication were finally included. Advances in drug development against HCoV, especially SARS-CoV-2, are summarized under three categories: antiviral drugs aimed at inhibiting the HCoV proliferation process, drugs acting on the host's immune system, and drugs derived from plants with potent activity. Furthermore, clinical trials of drugs targeting SARS-CoV-2 are summarized. CONCLUSIONS: During the spread of COVID-19 outbreak, great efforts have been made in therapeutic drug discovery against the virus, although the pharmacological effects and adverse reactions of some drugs under study are still unclear. However, well-designed high-quality studies are needed to further study the effectiveness and safety of these potential drugs so as to provide valid recommendations for better control of the COVID-19 pandemic.

Robust Membrane for Osmotic Energy Harvesting from Organic Solutions.

Using particulate nanochannels for desired ions transport is a potential technology for nanofluidic osmotic energy harvesting. However, the finite fresh water as an essential part of this harvesting system limits its development. Therefore, developing a robust membrane for harvesting energy from other solutions such as waste organic solutions is attractive. Here, we develop bioinspired membrane based on boron nitride flakes and aramid nanofibers with nanochannels via a layer-by-layer assembly technique for harvesting nanofluidic energy from organic solutions directly. Enhancement of the synergistic effect of the boron nitride flakes and aramid nanofibers endows the aramid-boron nitride (ABN) membrane with a superstrong mechanical performance (360 MPa). The ABN membrane showed a pressured-induced current in LiCl-methanol solution and NaCl-ethanol solution, respectively. More importantly, the ABN membrane exhibited outstanding stable and high-energy harvesting with salinity gradient dependence in LiCl-methanol, LiCl-ethanol, and NaCl-ethanol solutions, respectively. Impressively, the voltage produced from the organic solutions (LiCl-methanol, Ch/Cl = 1000) can power the transistor and it works well for 1 h as a gate voltage. The design of bioinspired membrane enables a robust and efficient harvesting of osmotic energy from organic solutions.

Fiber organic electrochemical transistors based on multi-walled carbon nanotube and polypyrrole composites for noninvasive lactate sensing.

Multi-walled carbon nanotubes (MWCNT) play a synergistic role with conducting polymer in practical applications such as biological sensing. In this paper, multi-walled carbon nanotube and polypyrrole (PPy) composites were prepared on a fiber surface for the first time, and their morphology and electrical properties were characterized. Compared with PPy-coated fiber, the presence of carbon nanotubes induced the growth of large areas of PPy nanowires. In addition, fiber organic electrochemical transistors (FECTs) based on PPy and MWCNT were assembled, showing a higher on/off ratio, better stability, and greater flexibility. The lactate biosensor based on FECTs exhibits high sensitivity, with a correlation coefficient of R = 0.9889, quick response time of 0.6-0.8 s, a wide linear response range of 1 nM-1 mM, and excellent selectivity for lactate. Furthermore, the lactate concentration in human sweat was successfully detected by a FECT-based sensor. The hybrid fibers can be easily woven and placed on fabric simply by stitching. This favorable performance of the FECT-based sensor makes it suitable for noninvasive sensing of lactate. Therefore, it provides a promising platform for future use in healthcare and detection applications. Graphical abstract.

Large-Area, Wearable, Self-Powered Pressure-Temperature Sensor Based on 3D Thermoelectric Spacer Fabric.

The rapid development of wearable devices puts forward higher requirements for mass-produced integrated smart systems that incorporate multiple electric components, such as energy supplying, multisensing, and communicating. To synchronously realize continuously self-powering, multifunctional sensing, distinguish signals from different stimuli, and productively design and fabricate a large-area sensing array, an all-fabric-based self-powered pressure-temperature-sensing electronic skin (e-skin) was prepared in this study by assembling highly flexible and compressible 3D spacer fabric (SF) and the thermoelectric poly(3,4-ethylenedioxythiophene)poly(styrenesulfonate) (PEDOT:PSS). The all-fabric-based e-skin can efficiently and accurately sense the temperature with a detection resolution of 0.1 K and a response time of 1 s, as well as pressure within a wide range of 200 Pa to 200 kPa and a fast response time of 80 ms. The electricity necessary for driving the sensor can be provided by the temperature difference between the body and environment. Notably, independent voltage and current signals can be generated and read out under the simultaneous temperature-pressure stimuli. For the first time, a real waistcoat-like e-skin with electricity-generating and pressure-temperature-sensing functions on the whole area was designed and prepared by a simple and easy to scale-up production method. All of these features make the developed all-fabric self-powered sensor have very promising applications.

Clinical characteristics and endoscopic treatment of hematospermia with postcoital hematuria.

BACKGROUND: Recurrent hematospermia accompanied by postejaculatory hematuria is a very rare phenomenon, has not been well understood in the clinical setting, and usually leads to misdiagnosis and mistreatment. The aim of this study was to summarize the clinical characteristics, etiologic diagnosis, and endoscopic treatment of hematospermia with postcoital hematuria. METHODS: We collected the clinical data from 39 patients of hematospermia with postcoital hematuria, who were admitted to our hospital from May 2014 to October 2019. The etiologic diagnostic process and endoscopic surgery were analyzed retrospectively, and we observed and evaluated the efficacy and any complications during follow-up. RESULTS: The average age of the 39 patients was 44.1 years (range, 18-61 years), and the disease history ranged from 1 month to 20 years, with a median duration of 24 months. All of the patients were observed by urethrocystoscopy, which showed 38 cases of posterior urethral hemangioma (PUH) or abnormal varicose vessels, and 1 case of anterior urethral hemangioma. Of these, 18 patients underwent transurethral resection of urethral hemangioma, and 21 patients underwent transurethral electrocauterization. Postoperative follow-up ranged from 1 to 56 months, with a median of 16 months. The symptoms disappeared in 37 patients and recurred in 2 patients two to 3 months after the operation. The two recurrent patients were treated again by transurethral electrocauterization, and their symptoms then disappeared. CONCLUSIONS: PUH is the most common cause of hematospermia with postejaculatory hematuria. Herein, we demonstrated that transurethral resection or electrocauterization provides a safe, effective, and minimally invasive method for the treatment of PUH.

Liver Chemistries in COVID-19 Patients with Survival or Death: A Meta-Analysis

Background and AimsAlthough abnormal liver chemistries are linked to higher risk of death related to coronavirus disease (COVID-19), liver manifestations may be diverse and even confused. Thus, we performed a meta-analysis of published liver manifestations and described the liver damage in COVID-19 patients with death or survival. MethodsWe searched PubMed, Google Scholar, medRxiv, bioRxiv, Cochrane Library, Embase, and three Chinese electronic databases through April 22, 2020. We analyzed pooled data on liver chemistries stratified by the main clinical outcome of COVID-19 using a fixed or random-effects model. ResultsIn the meta-analysis of 18 studies, which included a total of 2,862 patients, the pooled mean alanine aminotransferase (ALT) was 30.9 IU/L in the COVID-19 patients with death and 26.3 IU/L in the COVID-19 patients discharged alive (p < 0.0001). The pooled mean aspartate aminotransferase (AST) level was 45.3 IU/L in the COVID-19 patients with death while 30.1 IU/L in the patients discharged alive (p < 0.0001). Compared with the discharged alive cases, the dead cases tended to have lower albumin levels but longer prothrombin time, and international standardized ratio. ConclusionsIn this meta-analysis, according to the main clinical outcome of COVID-19, we comprehensively described three patterns of liver impairment related to COVID-19, hepatocellular injury, cholestasis, and hepatocellular disfunction. Patients died from COVID-19 tend to have different liver chemistries from those are discharged alive. Close monitoring of liver chemistries provides an early warning against COVID-19 related death. Lay SummaryAbnormal liver chemistries are linked to higher risk of death related to coronavirus disease (COVID-19). We performed a meta-analysis of 18 studies that included a total of 2,862 patients with COVID-19. We noted that patients died from COVID-19 tend to have different liver chemistries from those are discharged alive and close monitoring of liver chemistries provides early warning against COVID-19 related death.

Liver Chemistries in Patients with Severe or Non-Severe COVID-19: a Meta-Analysis

Background and AimsCumulating observations have indicated that patients with coronavirus disease (COVID-19) undergo different patterns of liver impairment. We performed a meta-analysis of published liver manifestations and described the liver damage in COVID-19. MethodsWe searched PubMed, Google Scholar, Embase, Cochrane Library, medRxiv, bioRxiv, and three Chinese electronic databases through April 18, 2020, in accordance with the Preferred Reporting Items for Meta-Analyses. We analyzed pooled data on liver chemistries stratified by COVID-19 severity using a fixed or random-effects model. ResultsIn the meta-analysis of 37 studies, which included a total of 6,235 patients, the pooled mean alanine aminotransferase (ALT) was 36.4 IU/L in the severe COVID-19 cases and 27.8 IU/L in the non-severe cases (95% confidence interval [CI]: - 9.4 to - 5.1, p < 0.0001). The pooled mean aspartate aminotransferase (AST) was 46.8 IU/L in the severe cases and 30.4 IU/L in the non-severe cases (95% CI: - 15.1 to - 10.4, p < 0.0001). Furthermore, regardless of disease severity, the AST level is often higher than the ALT level. Compared with the non-severe cases, the severe cases tended to have higher {gamma}-glutamyltransferase levels but lower albumin levels. ConclusionsIn this meta-analysis, we comprehensively described three patterns of liver impairment related to COVID-19, namely hepatocellular injury, cholestasis, and hepatocellular disfunction, according to COVID-19 severity. Patients with abnormal liver test results are at higher risk of progression to severe disease. Close monitoring of liver chemistries provides an early warning against disease progression. Lay SummaryData on abnormal liver chemistries related to coronavirus disease (COVID-19) are cumulating but are potentially confusing. We performed a meta-analysis of 37 studies that included a total of 6,235 patients with COVID-19. We noted that patients with abnormal liver test results are at higher risk of progression to severe disease and close monitoring of liver chemistries provides early warning against disease progression.

Microscopic replantation of completely amputated penis and testes: a case report and literature review.

OBJECTIVE: The aim of this study was to summarize in a literature review our treatment experience involving microscopic replantation in a rare case of a completely amputated penis and testes. PATIENT AND METHODS: The penis and testes were completely amputated due to self-mutilation. The 26-year-old patient immediately underwent microscopic replantation of the penis and testes after pre-operative preparation. Potent anti-infectives and anti-depressives, and microcirculation-improving hyperbaric oxygen therapy were utilized after surgery. RESULTS: The time between the amputation and surgery was about 10 h. The patient was followed for 12 months post-surgery. The replanted penis recovered and the patient could urinate normally in the standing position with a maximal urinary flow rate of 20 ml/s. The testes also survived, but their size showed obvious atrophy. The serum testosterone level at 2 months after the operation was 120 ng/dL (normal reference range: 175-781 ng/dL). Erectile function gradually recovered after androgen replacement therapy. CONCLUSION: Complete amputation of the penis and testis is very rare. Efforts should be made to perform the replantation surgery as soon as possible. Microscopic surgical techniques for elaborate vascular and neural anastomosis constitute the basis for a successful replantation. Post-operative comprehensive treatment such as strong anti-infection, analgesia, anti-depression, improvement of microcirculation, and hyperbaric oxygen is crucial for the survival and functional recovery of replanted organs.