Symbiotic Microorganisms and Their Different Association Types in Aquatic and Semiaquatic Bugs.

True bugs (Hemiptera, suborder Heteroptera) constitute the largest suborder of nonholometabolous insects and occupy a wide range of habitats various from terrestrial to semiaquatic to aquatic niches. The transition and occupation of these diverse habitats impose various challenges to true bugs, including access to oxygen for the aquatic species and plant defense for the terrestrial phytophagans. Although numerous studies have demonstrated that microorganisms can provide multiple benefits to terrestrial host insects, a systematic study with comprehensive higher taxa sampling that represents aquatic and semiaquatic habitats is still lacking. To explore the role of symbiotic microorganisms in true bug adaptations, 204 samples belonging to all seven infraorders of Heteroptera were investigated, representing approximately 85% of its superfamilies and almost all known habitats. The symbiotic microbial communities of these insects were analyzed based on the full-length amplicons of the bacterial 16S rRNA gene and fungal ITS region. Bacterial communities varied among hosts inhabiting terrestrial, semiaquatic, and aquatic habitats, while fungal communities were more related to the geographical distribution of the hosts. Interestingly, co-occurrence networks showed that species inhabiting similar habitats shared symbiotic microorganism association types. Moreover, functional prediction analyses showed that the symbiotic bacterial community of aquatic species displayed richer amino acid and lipid metabolism pathways, while plant-feeding true bugs benefited more from the symbiont-provided xenobiotics biodegradation pathway. These results deepened the recognition that symbiotic microorganisms were likely to help heteropterans occupy diverse ecological habitats and provided a reference framework for further studies on how microorganisms affect host insects living in various habitats. IMPORTANCE Symbiotic bacteria and fungi generally colonize insects and provide various benefits for hosts. Although numerous studies have investigated symbionts in terrestrial plant-feeding insects, explorations of symbiotic bacterial and fungal communities in aquatic and semiaquatic insects are rare. In this study, the symbiotic microorganisms of 204 aquatic, semiaquatic, and terrestrial true bugs were explored. This comprehensive taxon sampling covers ~85% of the superfamilies of true bugs and most insect habitats. Analyses of the diversity of symbionts demonstrated that the symbiotic microbial diversities of true bugs were mainly affected by host habitats. Co-occurrence networks showed that true bugs inhabiting similar habitats shared symbiotic microbial association types. These correlations between symbionts and hosts together with the functions of bacterial communities indicated that symbiotic microbial communities may help true bugs adapt to (semi)aquatic habitats.

Deep learning for locally advanced nasopharyngeal carcinoma prognostication based on pre- and post-treatment MRI.

PURPOSE: We aimed to predict the prognosis of advanced nasopharyngeal carcinoma (stage Ⅲ-Ⅳa) using Pre- and Post-treatment MR images based on deep learning (DL). METHODS: A total of 206 patients with primary nasopharyngeal carcinoma who were diagnosed and treated at the Renmin Hospital of Wuhan University between June 2012 and January 2018 were retrospectively selected. A rectangular region of interest (ROI), which included the tumor area, surrounding tissues and organs, was delineated on each Pre- and Post-treatment MR image. Two Inception-Resnet-V2 based transfer learning models, named Pre-model and Post-model, were trained with the Pre-treatment images and the Post-treatment images, respectively. In addition, an ensemble learning model based on the Pre-model and Post-models was established. The three established models were evaluated by receiver operating characteristic curve (ROC), confusion matrix, and Harrell's concordance indices (C-index). High-risk-related gradient-weighted class activation mapping (Grad-CAM) images were developed according to the DL models. RESULTS: The Pre-model, Post-model, and ensemble model displayed a C-index of 0.717 (95% CI: 0.639 to 0.795), 0.811 (95% CI: 0.745-0.877), 0.830 (95% CI: 0.767-0.893), and AUC of 0.741 (95% CI: 0.584-0.900), 0.806 (95% CI: 0.670-0.942), and 0.842 (95% CI: 0.718-0.967) for the test cohort, respectively. In comparison with the models, the performance of Post-model was better than the performance of Pre-model, which indicated the importance of Post-treatment images for prognosis prediction. All three DL models performed better than the TNM staging system (0.723, 95% CI: 0.567-0.879). The captured features presented on Grad-CAM images suggested that the areas around the tumor and lymph nodes were related to the prognosis of the tumor. CONCLUSIONS: The three established DL models based on Pre- and Post-treatment MR images have a better performance than TNM staging. Post-treatment MR images are of great significance for prognosis prediction and could contribute to clinical decision-making.

Artificial intelligence computed tomography helps evaluate the severity of COVID-19 patients: A retrospective study.

BACKGROUND: Computed tomography (CT) is a noninvasive imaging approach to assist the early diagnosis of pneumonia. However, coronavirus disease 2019 (COVID-19) shares similar imaging features with other types of pneumonia, which makes differential diagnosis problematic. Artificial intelligence (AI) has been proven successful in the medical imaging field, which has helped disease identification. However, whether AI can be used to identify the severity of COVID-19 is still underdetermined. METHODS: Data were extracted from 140 patients with confirmed COVID-19. The severity of COVID-19 patients (severe vs. non-severe) was defined at admission, according to American Thoracic Society (ATS) guidelines for community-acquired pneumonia (CAP). The AI-CT rating system constructed by Hangzhou YITU Healthcare Technology Co., Ltd. was used as the analysis tool to analyze chest CT images. RESULTS: A total of 117 diagnosed cases were enrolled, with 40 severe cases and 77 non-severe cases. Severe patients had more dyspnea symptoms on admission (12 vs. 3), higher acute physiology and chronic health evaluation (APACHE) II (9 vs. 4) and sequential organ failure assessment (SOFA) (3 vs. 1) scores, as well as higher CT semiquantitative rating scores (4 vs. 1) and AI-CT rating scores than non-severe patients (P<0.001). The AI-CT score was more predictive of the severity of COVID-19 (AUC=0.929), and ground-glass opacity (GGO) was more predictive of further intubation and mechanical ventilation (AUC=0.836). Furthermore, the CT semiquantitative score was linearly associated with the AI-CT rating system (Adj R 2=75.5%, P<0.001). CONCLUSIONS: AI technology could be used to evaluate disease severity in COVID-19 patients. Although it could not be considered an independent factor, there was no doubt that GGOs displayed more predictive value for further mechanical ventilation.

Surveillance on drug resistance of Staphylococcus aureus from bloodstream infection in Shandong, 2017-2020 / 中国热带医学

@#Abstract: Objective　To analyze the drug resistance of Staphylococcus aureus in blood samples of children and adults from 50 hospitals in Shandong Province, and to understand the drug sensitivity characteristics of Staphylococcus aureus bloodstream infection (BSI), so as to provide reference for clinical experience. Methods　The distribution and drug resistance of Staphylococcus aureus isolated from blood samples from 50 hospitals in Shandong province from 2017 to 2020 were analyzed based on the Cooperative Research Network of Pediatric Bacterial and Fungal Resistance Monitoring in Shandong Province. Meanwhile, the drug sensitivity characteristics of Staphylococcus aureus were divided into children group (<14 years old) and adult group (≥14 years old). The data were analyzed by Whonet 5.6 and SPSS 22.0 with reference to CLSI 2021 M100 document standard judgment results. Results　A total of 3 661 Staphylococcus aureus strains were collected from 50 medical institutions in Shandong Province, including 675 in 2017, 870 in 2018, 1 080 in 2019, and 1 036 in 2020. The drug resistance rates of multiple antibiotics in blood culture methicillin-resistant Staphylococcus aureus (MRSA) group and methicillin-sensitive Staphylococcus aureus (MSSA) group were significantly different (P<0.05). There were significant differences in antibiotic resistance rates between adult group and children group (P<0.05). The overall detection rate of MRSA was 27.5%, and no staphylococcus aureus strains resistant to vancomycin, linezolid and tigecycline were found. Conclusion　The detection rate of MRSA strains decreased continuously and increased by 2020. The detection rate of MRSA in adult group was lower than that in children group, suggesting that we should pay attention to the monitoring of bacterial resistance in children group, to the management of multiple resistant bacteria and rational use of antibacterial drugs.

Abnormal intrinsic functional network hubs in diabetic retinopathy patients.

BACKGROUND: However, whether the whole-brain functional network hub changes occur in diabetic retinopathy patients remains unknown. PURPOSE: The purpose of the study was to investigate the function network centrality and connectivity changes in diabetic retinopathy patients using the voxel-wise degree centrality method. MATERIALS AND METHODS: Thirty-four diabetic retinopathy patients (18 male and 16 female) and 38 healthy controls (18 male and 20 female) closely matched in age, sex, and education were enrolled in the study. Graph theory-based network analysis was performed to investigate the degree centrality between two groups. RESULTS: Compared with healthy controls, diabetic retinopathy patients had significantly higher degree centrality values in the pons and bilateral caudate and had significantly lower degree centrality values in the left lingual and right lingual, and right angular/middle occipital gyrus (MOG). Moreover, diabetic retinopathy patients exhibited increased functional connectivity between the bilateral lingual and right cerebellum lobe and right fusiform/bilateral caudate and increased functional connectivity between the right angular/MOG and bilateral anterior cingulum and right cuneus/bilateral precuneus and increased functional connectivity between the bilateral caudate and right lingual and right superior occipital gyrus. In contrast, diabetic retinopathy patients showed decreased functional connectivity between bilateral lingual and left lingual and right lingual and left superior occipital gyrus and decreased functional connectivity between the angular/MOG and right inferior occipital gyrus/right fusiform and left MOG/inferior occipital gyrus and decreased functional connectivity between the bilateral caudate and bilateral cerebellum crus1. CONCLUSION: Our results highlight that reorganization of the hierarchy of the cortical connectivity network related to visual network.

Altered Temporal Dynamic Intrinsic Brain Activity in Late Blindness.

Previous neuroimaging studies demonstrated that visual deprivation triggers significant crossmodal plasticity in the functional and structural architecture of the brain. However, prior neuroimaging studies focused on the static brain activity in blindness. It remains unknown whether alterations of dynamic intrinsic brain activity occur in late blindness (LB). This study investigated dynamic intrinsic brain activity changes in individuals with late blindness by assessing the dynamic amplitude of low-frequency fluctuations (dALFFs) using sliding-window analyses. Forty-one cases of late blindness (LB) (29 males and 12 females, mean age: 39.70 ± 12.66 years) and 48 sighted controls (SCs) (17 males and 31 females, mean age: 43.23 ± 13.40 years) closely matched in age, sex, and education level were enrolled in this study. The dALFF with sliding-window analyses was used to compare the difference in dynamic intrinsic brain activity between the two groups. Compared with SCs, individuals with LB exhibited significantly lower dALFF values in the bilateral lingual gyrus (LING)/calcarine (CAL) and left thalamus (THA). LB cases also showed considerably decreased dFC values between the bilateral LING/CAL and the left middle frontal gyrus (MFG) and between the left THA and the right LING/cerebelum_6 (CER) (two-tailed, voxel-level P < 0.01, Gaussian random field (GRF) correction, cluster-level P < 0.05). Our study demonstrated that LB individuals showed lower-temporal variability of dALFF in the visual cortices and thalamus, suggesting lower flexibility of visual thalamocortical activity, which might reflect impaired visual processing in LB individuals. These findings indicate that abnormal dynamic intrinsic brain activity might be involved in the neurophysiological mechanisms of LB.

Pulmonary pathology of early-phase COVID-19 pneumonia in a patient with a benign lung lesion.

AIMS: An ongoing outbreak of 2019 novel coronavirus (CoV) disease (COVID-19), caused by severe acute respiratory syndrome (SARS) CoV-2, has been spreading in multiple countries. One of the reasons for the rapid spread is that the virus can be transmitted from infected individuals without symptoms. Revealing the pathological features of early-phase COVID-19 pneumonia is important for understanding of its pathogenesis. The aim of this study was to explore the pulmonary pathology of early-phase COVID-19 pneumonia in a patient with a benign lung lesion. METHODS AND RESULTS: We analysed the pathological changes in lung tissue from a 55-year-old female patient with early-phase SARS-CoV-2 infection. In this case, right lower lobectomy was performed for a benign pulmonary nodule. Detailed clinical, laboratory and radiological data were also examined. This patient was confirmed to have preoperative SARS-CoV-2 infection by the use of real-time reverse transcription polymerase chain reaction and RNA in-situ hybridisation on surgically removed lung tissues. Histologically, COVID-19 pneumonia was characterised by exudative inflammation. The closer to the visceral pleura, the more severe the exudation of monocytes and lymphocytes. Perivascular inflammatory infiltration, intra-alveolar multinucleated giant cells, pneumocyte hyperplasia and intracytoplasmic viral-like inclusion bodies were seen. However, fibrinous exudate and hyaline membrane formation, which were typical pulmonary features of SARS pneumonia, were not evident in this case. Immunohistochemical staining results showed an abnormal accumulation of CD4+ helper T lymphocytes and CD163+ M2 macrophages in the lung tissue. CONCLUSION: The results highlighted the pulmonary pathological changes of early-phase SARS-CoV-2 infection, and suggested a role of immune dysfunction in the pathogenesis of COVID-19 pneumonia.

Altered functional connectivity of primary visual cortex in late blindness.

BACKGROUND: Previous studies demonstrated that early blindness is associated with abnormal intrinsic functional connectivity (FC) between the primary visual cortex (V1) and other sensory areas. However, the V1 pattern of spontaneous neural activity occurring in late blindness (LB) remains unknown. The purpose of this study was to investigate the intrinsic FC patterns of V1 in LB. MATERIALS AND METHODS: Thirty LB individuals (18 males and 12 females; mean age: 38.76±14.43 years) and 30 sighted controls (SCs) individuals (18 males and 12 females; mean age: 38.67±13.85 years) closely matched for age, sex, and education, underwent resting-state magnetic resonance imaging scans. Region of interest analysis was performed to extract the correlation coefficient matrix among each pair of Brodmann area (BA) 17 and FC between V1 and vision-related subcortical nuclei. RESULTS: Compared with SCs, LB individuals showed a decreased FC between the left V1 and the bilateral cuneus (CUN)/lingual gyrus (LGG)/calcarine (CAL) (BA 18/19/30) and left precentral gyrus (PreCG) and the postcentral gyrus (PostCG) (BA 2/3/4). Also, LB individuals showed a decreased FC between the right V1 and the bilateral CUN/LGG/CAL (BA 18/19/30) and the left PreCG and PostCG (BA 2/3/4/6) (voxel-level: P<0.01, cluster-level: P<0.05). Meanwhile, LB individuals showed a decreased FC between the left V1 and the right V1 and increased FC between the left V1 and the right superior colliculus, the right V1, and the left hippocampus (P<0.05). Moreover, a positive correlation was observed between the onset age of blindness and FC values in V1 to CUN/LGG/CAL in LB. CONCLUSION: Our results highlighted that LB induces a decreased FC between V1 and higher visual areas, motor cortices, and somatosensory cortices at rest. This might indicate that LB humans could present with impaired top-down modulations, visual imagery, and vision-motor function.

Use of serum and urinary soluble sFlt-1 and PLGF in the diagnosis of preeclampsia.

OBJECTIVE: Preeclampsia (PE) is a disorder of pregnancy marked by hypertension and proteinuria with no known treatment aside from pregnancy termination. The pathogenesis of PE is poorly understood, but is thought to originate in the placenta. We assessed the value of measuring serum and urinary soluble deformylase-like tyrosine kinase receptor 1 (sFlt-1), a known target of placental factors, and placental growth factor (PLGF), a key placental signaling molecule, in the diagnosis of PE. METHODS: Eighty patients with PE were classified as either exhibiting mild (44 cases) or severe (36 cases) symptoms of PE. Forty normal pregnant women were selected as controls. Serum and urinary PLGF and sFlt-1 levels, along with the ratio of sFlt-1 to PLGF, were compared across groups. RESULTS: Serum and urinary sFlt-1 and sFlt-1/PLGF ratios in severe PE patients were significantly higher than those in the mild PE group, and measurements from mild PE patients were significantly higher than controls (all P values <0.01). The serum and urinary PLGF levels in severe PE patients were significantly lower than mild PE patients, and mild PE patients had significantly lower PLGF levels than controls (all P values <0.01). As expected, serum sFlt-1 and PLGF levels and ratios were highly correlated with urinary sFlt-1 and PLGF levels and ratios. CONCLUSIONS: The severity of PE was closely correlated with these measurements, suggesting that they may be useful tools in the diagnosis and evaluation of PE.

[Study on the growth of orbital volume in individuals at different ages by computed tomography].

OBJECTIVE: To study the growth aspects of orbital volume and to establish the normal value of orbital volume by computed tomography (CT). METHODS: One hundred and twenty three individuals without eye diseases (64 males, 59 females) were divided into 5 groups according to the age. Orbital volume and length of horizontal transverse axis and anterior-posterior axis of the eye were measured at different levels in original or reconstructive CT images. The relationship between orbital volume and age, gender and eyeball volume was analyzed. RESULTS: There was no difference between the left and right orbital volume in all age groups. Orbital volume grew rapidly before 20 years of old. Mean orbital volume in males aged 17 and females aged 13 was 23.54 and 21.75 ml, respectively, which reached 95% of the adult orbital volume. In normal adult, orbital volume in the male was larger than that of the female. The mean orbital volume of adult male and female was (25.04 +/- 2.37) ml and (22.89 +/- 2.67) ml, respectively. A strong linear correlation was presented between the age and orbital volume (P < 0.05). The difference of orbital volume between the male and female was statistically non-significant before 14 years old (P = 0.315). The growth of eyeball volume was consistent with that of the orbital volume, the ratio of eyeball/orbit volume was decreased with age from 0.40 to 0.26. CONCLUSIONS: There is no difference between the right and left orbital volume. Orbital volume is correlated with age and gender. Orbital volume grows rapidly before 20 years of old and still grows slowly after 40 years old.

[Effect of combined decompression operation on middle and late stage cerebral herniation].

OBJECTIVE: To observe the effect of combined decompression operation on patients with severe traumatic brain injury complicated by tentorial cerebral herniation. METHODS: Ninety-seven patients with an admission Glasgow Coma Scale score 3-5 were randomly divided into two groups: combined decompression group (n=46), in whom tentorium cerebelli was incised (2-4 cm) combined with bone flap craniectomy decompression [(10-15)cm x (15-17)cm], and conventional temporoparietal craniectomy group (n=51). CT scanning was performed in the patients before and after the operation. The patients of both groups received routine treatment and followed up for 1-32 months (mean 7 months) after the operation. The clinical symptoms, change in intracranial pressure and incidence of complications were compared between the two groups. RESULTS: The efficacious rate was 80.4% (37/46) in the combined decompression group, and among them 27 patients were cured (58.7%) and 10 patients remained to have moderate disability(21.7%). Nine patients (19.6%) died after combined decompression. However, in patients with conventional temporoparietal craniectomy decompression, favorable outcome was only found in 6 cases(11.8%), moderate disability accounted for 21.6% of patients, and 34 patients died(66.6%). In patients with combined decompression, the intracranial pressure was more efficiently lowered compared with conventional craniectomy decompression(P<0.01). Furthermore the incidence of acute brain edema, incisional herniation, traumatic epilepsy, occipital cerebral infarct and cerebro-spinal fluid(CSF) leakage were lower in combined decompression group compared with conventional craniectomy group (P<0.05 or P<0.01). The incidence of intracranial infection was not significantly different between two groups (P>0.05). CONCLUSION: Combined decompression is preferable to routine temporoparietal craniectomy for patients with severe head injury complicated by tentorial herniation.

[Clinical observation of one stage cranioplasty for skull defect with self-cranial bone powder].

OBJECTIVE: To investigate the clinical application of self-cranial bone powder in one stage cranioplasty. METHODS: From October 1999 to December 2002, self-cranial bone powder and medical adhesive were used to repair the skull defect, for one stage cranioplasty, caused by operations on cranium in 128 cases of severe dangerous craniocerebral injury, acute intracranial hematome, sick skull and intracranial tumor. The bone growth was observed by CT or X-ray examination 3-24 months after replantation of cranioplasty. RESULTS: The decompression and cranioplasty were performed simultaneously, the time prolonged 5-10 minutes than that of routine, the appearance of repaired cranial bone was normal, without concavity and convexity. After 12 months of operation, the replanted bone merged with the normal bone completely, with normal appearance. The operation successful rate was 96.1% (123/125) without any complication. Only five cases were not better in growing because of less bone powder, but without cerebral pulse and defective syndrome. All the cases did not need secondary cranioplasty. CONCLUSION: The effect of cranioplasty with self- cranial bone powder effect is good in taking shape. This new method can avoid the traditional secondary cranioplasty for skull defect and complications.