Association Between Mycophenolate Mofetil Use and Subsequent Infections Among Hospitalized Patients with Systemic Lupus Erythematosus: A Nested Case-Control Study.

INTRODUCTION: The association between mycophenolate mofetil (MMF) and infection in patients with systemic lupus erythematosus (SLE) has not been clarified. This study evaluated the degree and factors in effect of MMF use on infection in patients with SLE. METHODS: A hospitalized-based observational study was conducted to collect medical records on patients with SLE during 2010-2021. A nested case-control study was performed among 3339 patients with SLE, including 1577 cases and 1762 controls by whether they developed any type of infection. The exposure of MMF use was determined within 1 year before diagnosed infection or the end of follow-up. Logistic regression was used to estimate the odds ratio (OR) and 95% confidence interval (CI) for association between MMF and subsequent infection. RESULTS: MMF was significantly associated with the risk of overall infection (adjusted OR 1.90, 95% CI 1.48-2.44) and different types of infections, including bacterial infection (adjusted OR 2.07, 95% CI 1.55-2.75), viral infection (adjusted OR 1.92, 95% CI 1.23-3.01), and opportunistic infection (adjusted OR 2.13, 95% CI 1.31-3.46). The top three risks of specific types of infections were bacteremia/septicemia, urinary tract infection/pyelonephritis, and herpes zoster. Stratification analysis showed risk of overall infection increased especially in MMF users with age over 55 years, diabetes, central nervous system involvement, and thrombocytopenia. Moreover, the risk of infection increased with increasing dosage and duration of MMF use. Additionally, the combination of MMF with CYC and other immunosuppressants significantly increases the risk of infections compared to using a single one. CONCLUSIONS: MMF use is associated with various type of infections in patients with SLE, particularly in those with longer use, older age, complications with comorbidities, and concomitant use of CYC or other immunosuppressants.

Factors associated with 25-hydroxyvitamin D level in Chinese hospitalized patients with systemic lupus erythematosus: a retrospective cohort study.

We aimed to investigate the factors associated with vitamin D deficiency and changes in 25 (OH)D levels, as well as the impact of those changes on disease activity and renal function among SLE patients. This retrospective cohort study was based on the medical records of SLE patients hospitalized between 2010 and 2021. We collected relevant information from this patient population. Logistic regression analysis was employed to determine the factors associated with vitamin D deficiency and increased 25 (OH)D levels, and we calculated the odds ratios (ORs) and 95% confidence intervals (CIs) accordingly. At baseline, among the 1257 SLE patients, the median and interquartile range of 25 (OH)D levels were 14 (9, 20) ng/ml, with 953 (75.8%) patients exhibiting 25 (OH)D deficiency (< 20 ng/ml). The presence of 25 (OH)D deficiency was found to be associated with renal involvement and a high glucocorticoid (GC) maintenance dose. Among the 383 patients who were followed up for an average of 18 months, an increase of at least 100% in 25 (OH)D levels was positively associated with a decreased GC maintenance dose and vitamin D3 supplementation, with adjusted odds ratios(OR) (95% confidence interval [CI]) of 2.16 (1.02, 4.59) and 1300 (70, 22300), respectively. Furthermore, an increased level of 25 (OH)D was significantly associated with a decrease in the Disease Activity Index 2000 score and the urinary protein/creatinine ratio. Patients with SLE have low vitamin D levels, especially those with impaired kidney function. Increased 25 (OH)D levels can be achieved through supplementation with high doses of vitamin D3 and are associated with improvements in disease activity and the urinary protein/creatinine ratio.

To construct a three-category radiomics model based on multi-parameter magnetic resonance imaging to distinguish prostatitis for athletic patients

Prostatitis is a very common disease, with the growth of age, in addition to wrinkles, weight in the longer, the male prostate may also become longer, so there is prostatic hyperplasia (BPH), when its gradual proliferation compression bladder outlet and urethra, will cause dysuria and other symptoms. Simply put, prostatitis causes hyperplasia of the prostate, and prostatitis increases the risk of prostate cancer (Pca). Prostate disease afflicts many men. Therefore, accurate diagnosis of prostate disease is very important for athletic patients to seek medical treatment in time. Multiparametric magnetic resonance imaging (mp-MRI) is a non-invasive imaging technique with superior diagnostic performance compared to other imaging modalities, such as ultrasound and computed tomography. It is widely used in the diagnosis of prostate disease. Advances in science and technology, high-field magnets and new magnetic coil designs (including intra-rectal coils and multichannel surface coils), as well as more advanced software and computational algorithms, allow more sophisticated functional imaging to be incorporated into clinical imaging. The diagnosis of prostate disease has also become faster and more accurate, bringing good news to athletic patients. (AU)

Biodegradable smart materials with self-healing and shape memory function for wound healing.

Notwithstanding the rapid development of suture elastomers to meet the needs of practical surgery, utilizing the elastomers' self-healing function as a surgical suture to facilitate the healing of wounds has not been addressed. Here, a biodegradable aliphatic polycarbonate smart elastomer, mPEG113-b-PMBC n , was synthesized from aliphatic polycarbonate monomer with methoxy polyethylene glycol (mPEG113, 5.0 kDa) as initiator, which exhibited excellent mechanical properties, highly efficient self-repairing, and remarkable shape memory behavior. The polymers possess outstanding self-healing ability for 150 min. Meanwhile, after 46.33 ± 1.18 s, the temporary shape of the obtained polymer had been recovered. The results of biocompatibility tests reveal that the polymers have excellent biocompatibility and can be regarded as good biomedical materials. Then, in vivo experiments were used to prove the self-healing knotting ability of the polymers and quickly close a wound surface using a programmed shape at physiological temperature. The results demonstrated that the injury wound can be effectively healed compared with traditional sutures, which will offer new study suggestions for subsequent healing areas.

An improved self-supervised learning for EEG classification.

Motor Imagery EEG (MI-EEG) classification plays an important role in different Brain-Computer Interface (BCI) systems. Recently, deep learning has been widely used in the MI-EEG classification tasks, however this technology requires a large number of labeled training samples which are difficult to obtain, and insufficient labeled training samples will result in a degradation of the classification performance. To address the degradation problem, we investigate a Self-Supervised Learning (SSL) based MI-EEG classification method to reduce the dependence on a large number of labeled training samples. The proposed method includes a pretext task and a downstream classification one. In the pretext task, each MI-EEG is rearranged according to the temporal characteristic. A network is pre-trained using the original and rearranged MI-EEGs. In the downstream task, a MI-EEG classification network is firstly initialized by the network learned in the pretext task and then trained using a small number of the labeled training samples. A series of experiments are conducted on Data sets 1 and 2b of BCI competition IV and IVa of BCI competition III. In the case of one third of the labeled training samples, the proposed method can obtain an obvious improvement compared to the baseline network without using SSL. In the experiments under different percentages of the labeled training samples, the results show that the designed SSL strategy is effective and beneficial to improving the classification performance.

Construction of multi-layered Zn-modified TiO2 coating by ultrasound-auxiliary micro-arc oxidation: Microstructure and biological property.

Surfaces with desirable cytocompatibility and bactericidal ability are favoured for orthopaedic implants to stimulate osteogenic activity and to prevent implant-associated infection. In this work, we creatively introduce ultrasonic vibration (UV) to micro-arc oxidation (MAO) process and explore its influence on the microstructure, corrosion property and biological responses of Zn-modified TiO2 coating. With the introduction of UV, a uniform surface layer with homogeneously-distributed clusters could be produced as the outer layer, which possesses a fusion band with the underlying TiO2. The microstructural modification associated with UV results in the enhanced corrosion resistance, increased adhesive strength and improved biological performances of the resultant coating relative to that with the absence of UV. Hence, the ultrasonic auxiliary micro-arc oxidation (UMAO) is regarded as a promising surface modification method to produce Ti-based orthopaedic implants of high quality.

Dynamic changes of activator protein 1 and collagen I expression in the sclera of myopia guinea pigs.

AIM: To investigate the dynamic changes of activator protein 1 (AP1) and collagen I expression in the sclera of form-deprivation myopic model in guinea pigs. METHODS: A form-deprivation myopic model in guinea pigs were established with the left eye covered for 2 to 6wk (FDM group). Normal control group (n=25) were untreated. Changes in refractive power and axial length (AL) were measured and recorded at different time points. Expressions of AP1 and collagen 1 of the sclera were measured with Western blotting and reverse transcription-polymerase chain reaction (RT-PCR). The relationship between AP1 and collagen I levels was analyzed. RESULTS: After 0, 2, 4, 6wk, and 4/-1wk of form-deprivation, the diopter in the FDM group was gradually changed (2.08±0.31, -1.23±0.68, -4.17±0.58, -7.07±0.55, and -2.67±0.59 D, respectively, P<0.05), and the AL was gradually increased (5.90±0.38, 6.62±0.37, 7.30±0.35, 7.99±0.31, and 6.97±0.32 mm, respectively, P<0.05). With the prolongation of covered time, the protein expressions of AP1 and collagen I in the FDM group were gradually down-regulated (all P<0.05); the mRNA expressions of them were also gradually down-regulated (all P<0.05); and there was positive correlation between them. The control group had no obvious change in each index (all P>0.05). CONCLUSION: AP1 may be an important transcription factor involved in the regulation of collagen I synthesis and degradation during myopic scleral remodeling.

TRPV4 regulates migration and tube formation of human retinal capillary endothelial cells.

BACKGROUND: Ca2+ entry plays an important role in modulating endothelial cell migration and tube formation. Transient receptor potential cation channel subfamily V member 4 (TRPV4) is a Ca2+-permeable channel that is widely expressed in endothelial cells. It has been reported that TRPV4 is expressed in HRCECs and regulates Ca2+ entry. However, the function of TRPV4 in human retinal capillary endothelial cells (HRCECs) remains unknown. METHODS: In this study we used western blot and immunostaining assay to verify TRPV4 expression in HRCECs. And then we pretreated HRCECs with HC067047 and transfected with specific shRNA of TRPV4. The functional presence of TrpV4 was determined by using fluorescence, migration and tube formation assay in TrpV4 knockdown cells or control cells. RESULTS: Using western blot and immunostaining, we confirmed TRPV4 expression in HRCECs. Moreover, inhibition of TRPV4 using the specific inhibitor HC067047 and the knockdown of TRPV4 with shRNA significantly suppressed tube formation and migration by HRCECs. CONCLUSIONS: TRPV4 is essential for HRCEC migration and tube formation, and maybe a potential therapeutic target for retinal vascular diseases.

Expression and role of specificity protein 1 in the sclera remodeling of experimental myopia in guinea pigs.

AIM: To study the expression of collagen I and transcription factor specificity protein 1 (Sp1), a transforming growth factor-ß1 (TGF-ß1) downstream target, and reveal the impact of the TGF-ß1-Sp1 signaling pathway on collagen remodeling in myopic sclera. METHODS: Seventy-five 1-week-old guinea pigs were randomly divided into normal control, form deprivation myopia (FDM), and self-control groups. FDM was induced for different times using coverage with translucent latex balloons and FDM recovery was performed for 1wk after 4wk treatment; then, changes in refractive power and axial length were measured. Immunohistochemistry and reverse transcription-polymerase chain reaction were used to evaluate dynamic changes in collagen I and Sp1 expression in the sclera of guinea pigs with emmetropia and experimental myopia, and the relationship between collagen I and Sp1 levels was analyzed. RESULTS: In the FDM group, the refractive power was gradually changed (from 2.09±0.30 D at week 0 to -1.23±0.69 D, -4.17±0.59 D, -7.07±0.56 D, and -4.30±0.58 D at weeks 2, 4, 6, and 1wk after 4wk, respectively; P<0.05), indicating deepening of myopia. The axial length was increased (from 5.92±0.39 mm at week 0 to 6.62±0.36 mm, 7.30±0.34 mm, 7.99±0.32 mm, and 7.41±0.36 mm at weeks 2, 4, 6, and 1wk after 4wk; P<0.05). The mRNA and protein expression of Sp1 and collagen I in the sclera of the FDM group was lower than that of the control groups (P<0.05), and the reduction was eye-coverage time-dependent. Furthermore, correlation between Sp1 and collagen I down-regulation in the myopic sclera was observed. CONCLUSION: Our data indicate that transcription factor Sp1 may be involved in the regulation of type I collagen synthesis/degradation during myopic sclera remodeling, suggesting that TGF-ß1 signaling plays a role in the development and progression of myopia.

[Clinical research of intraoperative floppy iris syndrome during operation].

Intraoperative floppy iris syndrome (IFIS) has been recently identified as a new small pupil syndrome during phacoemulsification. This syndrome is characterized by three intraoperative features: a flaccid iris stroma that undulates and bellows in response to intraocular fluid currents; a propensity for the floppy iris stroma to prolapse toward the tip of phacoemulsification and side-port incisions despite proper wound construction; and progressive intraoperative pupil constriction despite standard preventive preoperative pharmacologic measures designed to prevent this. It is now mostly considered that IFIS is associated with the use of tamsolusin, a highly selective alpha-1A receptor antagonist for the treatment of benign prostatic hypertrophy. It is recommended that a careful history of the use of alpha-1 blocking agents be taken before cataract surgery to anticipate the occurrence of IFIS. A combination of strategies could decrease the complications of IFIS. These procedures include preoperative use of atropine, intracameral injection of dilute phenylephrine or epinephrine, the use of super-cohesive ophthalmic viscosurgical devices, lower phacoemulsification vacuum and aspiration settings and various iris hooks or pupil dilators.

Rapid method for the determination of amino acids in serum by capillary electrophoresis.

A rapid method for the determination of amino acids in serum is presented. The derivatization of amino acids with 2,4-dinitrofluorobenzene was performed in 0.5 M sodium borate (pH 9.5). The complete separation of derivatives of 16 amino acids and an internal standard (D-norleucine) was achieved within 8 min by capillary zone electrophoresis. The running buffer consisted of 30 mM sodium tetraborate (pH 9.8)-isopropanol-30% Brij 35 (825:150:25, v/v). The capillary used had an internal diameter of 75 microm and an effective length of 300 mm. A voltage of 28 kV was applied. Temperature was maintained at 15 degrees C. Detection was 360 nm. The assay was linear from 10 to 700 microM. The minimal detection limit was 2.5-7.9 microM. The recovery of amino acids added to serum samples was 86.3-107.4%. Within-run precision was 2.8-10.3%, and between-run precision was 3.5-11.6%. The concentrations of amino acids in serum of 32 patients with chronic renal failure were measured. Among them, the levels of serine, isoleucine and valine were significantly lower than those of healthy volunteers (P<0.01), but the concentrations of cystine, tryptophan and phenylane were significantly higher than those of healthy volunteers (P<0.01). The result showed that the method could be used for determining amino acids in clinical practice and scientific research.