Clinical manifestations of respiratory syncytial virus infection and the risk of wheezing and recurrent wheezing illness: a systematic review and meta-analysis.

BACKGROUND: Respiratory syncytial virus (RSV) infection in infants is a global health priority. We aimed to investigate the common manifestations of RSV infection by age group and human development index (HDI) level and to assess its association with the development of wheezing and recurrent wheezing illness. METHODS: We searched the literature published between January 1, 2010 and June 2, 2022 in seven databases. Outcomes included common manifestations and long-term respiratory outcomes of RSV infection in children. Random- and fixed-effect models were used to estimate the effect size and their 95% confidence intervals. Subgroup analysis was conducted by age and HDI levels. This review was registered in PROSPERO (CRD42022379401). RESULTS: The meta-analysis included 47 studies. The top five manifestations were cough (92%), nasal congestion (58%), rhinorrhea (53%), shortness of breath (50%), and dyspnea (47%). The clinical symptoms were most severe in infants. In our analysis, compared to very high and high HDI countries, fewer studies in medium HDI countries reported related manifestations, and no study in low HDI countries reported that. The RSV-infected infants were more likely to develop wheezing than the non-infected infants [odds ratio (OR), 3.12; 95% CI, 2.59-3.76] and had a higher risk of developing wheezing illnesses after recovery (OR, 2.60; 95% CI, 2.51-2.70). CONCLUSIONS: Cough and shortness of breath are common manifestations of RSV infection. More attention should be given to infants and areas with low HDI levels. The current findings confirm an association between RSV infection and wheezing or recurrent wheezing illness.

Clinical features and risk factors of severely and critically ill patients with COVID-19.

BACKGROUND: As of June 1, 2020, over 370000 coronavirus disease 2019 (COVID-19) deaths have been reported to the World Health Organization. However, the risk factors for patients with moderate-to-severe or severe-to-critical COVID-19 remain unclear. AIM: To explore the characteristics and predictive markers of severely and critically ill patients with COVID-19. METHODS: A retrospective study was conducted at the B11 Zhongfaxincheng campus and E1-3 Guanggu campus of Tongji Hospital affiliated with Huazhong University of Science and Technology in Wuhan. Patients with COVID-19 admitted from 1st February 2020 to 8th March 2020 were enrolled and categorized into 3 groups: The moderate group, severe group and critically ill group. Epidemiological data, demographic data, clinical symptoms and outcomes, complications, laboratory tests and radiographic examinations were collected retrospectively from the hospital information system and then compared between groups. RESULTS: A total of 126 patients were enrolled. There were 59 in the moderate group, 49 in the severe group, and 18 in the critically ill group. Multivariate logistic regression analysis showed that age [odd ratio (OR) = 1.055, 95% (confidence interval) CI: 1.099-1.104], elevated neutrophil-to-lymphocyte ratios (OR = 4.019, 95%CI: 1.045-15.467) and elevated high-sensitivity cardiac troponin I (OR = 10.126, 95%CI: 1.088 -94.247) were high-risk factors. CONCLUSION: The following indicators can help clinicians identify patients with severe COVID-19 at an early stage: age, an elevated neutrophil-to-lymphocyte ratio and high sensitivity cardiac troponin I.

An experimental study on stress-shielding effects of locked compression plates in fixing intact dog femur.

BACKGROUND: In orthopedic application, stress-shielding effects of implant materials cause bone loss, which often induces porosis, delayed bone healing, and other complications. We aimed to compare the stress-shielding effects of locked compression plate (LCP) and limited-contact dynamic compression plate (LC-DCP) in dogs with plate-fixed femurs. METHODS: Bilateral intact femurs of 24 adult dogs were fixed by adult forearm 9-hole titanium plates using minimally invasive plate osteosynthesis (MIPPO) technology, with LCP on the left and LC-DCP on the right femurs. Dogs were sacrificed at 6 weeks, 12 weeks, and 24 weeks after surgery, and bone specimens were used to evaluate the efficacies of different fixing methods on bones through X-ray, dual-energy X-ray absorptiometry (DEXA), histology, MicroCT, and biomechanics analyses. RESULTS: X-ray results showed significant callus formation and periosteal reaction in the LC-DCP group. Bone cell morphology, degree of osteoporosis, and bone mineral density (BMD) changes of the LCP group were significantly better than that of the LC-DCP group. MicroCT results showed that the LCP group had significantly reduced degree of cortical bone osteoporosis than the LC-DCP group. Tissue mineral density (TMD) in the LCP group was higher than that in the LC-DCP group at different time points (6 weeks, 12 weeks, and 24 weeks). Biomechanics analyses demonstrated that the compressive strength and flexural strength of bones fixed by LCP were better than that by LC-DCP. CONCLUSIONS: Stress-shielding effects of LCP are significantly weaker than that of LC-DCP, which is beneficial to new bone formation and fracture healing, and LCP can be widely used in clinic for fracture fixation.

Intrinsically Visible Light-Responsive Liquid Crystalline Physical Gels Driven by a Halogen Bond.

Photoresponsive physical gels using liquid crystals (LCs) as solvents have attracted great interest owing to their potential applications. But, current investigations mainly focus on UV light, which is not environment-friendly enough. On the other hand, the halogen bond is a novel tool for constructing supramolecular gels because of good hydrophobicity, high directionality, tunable strength, and large size of halogen atoms. Herein, to construct an LC physical gel with both the advantages of a halogen bond and visible light response, azopyridine-containing Azopy-C10 is chosen as a halogen bond acceptor, while 1,2-bis(2,3,5,6-tetrafluoro-4-iodophenyl)diazene is selected both as the halogen bond donor and for the intrinsically visible light response. Such a binary gelator can self-assemble in the anisotropic solvent of nematic LC 5CB to form an LC physical gel. It experiences the gel-to-sol transition by green light irradiation. As the gelator concentration increases, the saturation voltage increases, but the switch-off time decreases. The combination of the halogen bond and controllable visible light-responsive LC physical gel provides the feasibilities of manipulating these smart soft materials.

Visible light-triggered gel-to-sol transition in halogen-bond-based supramolecules.

Photoresponsive supramolecular gels have aroused continuous attention because of their extensive applications; however, most studies utilize UV light, which inevitably brings about some health and environmental issues. The halogen bond is an important driving force for constructing supramolecules due to its high directionality, tunable strength, good hydrophobicity, and large size of the halogen atoms. Yet, it still remains a formidable challenge to utilize halogen bonds as a driving force to fabricate a visible light responsive gel. In this work, to fabricate such a gel, azopyridine-containing Azopy-Cn (n = 8, 10, 12) was selected as a halogen bond acceptor, while 1,2-bis(2,3,5,6-tetrafluoro-4-iodophenyl)diazene (BTFIPD) was chosen as both the halogen bond donor and visible light responsive moiety. The visible light response of BTFIPD resulted from the significant separation of n-π* energy levels between trans and cis isomers due to the introduction of an electron-withdrawing group (fluorine) to azobenzene at the ortho-position. Interestingly, the gel exhibited a good gel-to-sol transition behavior upon green light irradiation. At the same time, the morphologies varied from uniform narrow flakes to broad sheets with increasing illumination time. We provide an environmentally-friendly visible light-triggered method to regulate the phase transition of supramolecular materials in applications ranging from energy conversion to information storage.

Molecular Mechanism for Improving Emulsification Efficiency of Soy Glycinin by Glycation with Soy Soluble Polysaccharide.

Glycation with carbohydrates has been considered to be an effective strategy to improve the emulsifying properties of plant storage globulins, but the knowledge is inconsistent and even contradictory. This work reported that the glycation with soy soluble polysaccharide (SSPS) progressively improved the emulsification efficiency of soy glycinin (SG) in a degree-of-glycation (DG)-dependent manner. The glycation occurred in both the acidic (A) and basic (B) polypeptides to a similar extent. The physicochemical and structural properties of glycated SG samples with different DG values of 0-35% were characterized. The emulsifying properties of unglycated and glycated SG were performed on the emulsions at an oil fraction of 0.3 and a protein concentration in the aqueous phase, produced using microfluidization as the emusification process. The glycation with increasing the DG led to a progressive decrease in solubility and surface hydrophobicity but remarkably increased the magnitude of ζ-potential. Dynamic latter scattering and spectroscopic results showed that the glycation resulted in a gradual dissociation of the 11S-form SG at the quaternary level (into different [AB] subunits), in a DG-dependent way, while their tertiary ([AB] subunits) and secondary structure were slightly affected. Besides the emulsification efficiency, the glycation progressively accelerated the droplet flocculation and facilitated the adsorption of the proteins at the interface and formation of bridged emulsions. The results demonstrated that the improvement of the emulsification efficiency of SG by the glycation with SSPS was largely attributed to the enhanced conformation flexibility at the [AB] subunit level as well as facilitated formation of bridged emulsions. It was also confirmed that once the glycated SG adsorbed at the interface, it would readily dissociated into subunits; the dissociated [AB] subunits exhibited an outstanding Pickering stabilization. The findings would be of importance for providing new knowledge about the molecular mechanism for the modification of emulsifying properties of oligomeric globulins by the glycation with polysaccharides.

Ovalbumin as an Outstanding Pickering Nanostabilizer for High Internal Phase Emulsions.

There is still a debate about the effectiveness of native globular proteins to perform as Pickering-like stabilizers for oil-in-water high internal phase emulsions (HIPEs). In the work, we report one native globular protein (ovalbumin) with strong structural integrity and high refolding ability, exhibits an outstanding Pickering stabilization for HIPEs. Ultrastable gel-like HIPEs can be formed through a facile one-pot homogenization even at a concentration as low as 0.2 wt %. The HIPEs formed in the protein-poor regime are a kind of self-supporting and remoldable hydrogel consisting of bridging droplets. The formed HIPEs also exhibit other unique characteristics, such as extraordinary coalescence stability (against prolonged storage or heating), susceptibility to freeze-thawing, enhanced oxidation stability (to encapsulated bioactives), and inhibited vaporization of volatile oils. The findings would be of importance for extending the HIPEs to be applied in food, cosmetic, and petroleum industries.

Prevalence and Antimicrobial Susceptibility of Mycobacterium abscessus in a General Hospital, China.

OBJECTIVE: To gain greater insight into the prevalence drug resistant profiles of M. abscessus from a general hospital in Beijing, China. METHODS: Partial gene sequencing of 16S, hsp65, and rpoB were used to distinguish the species of NTM isolates. All strains identified as M. abscessus were further enrolled in the drug susceptibility testing by using broth microdilution method. RESULTS: We found that M. avium complex was the most frequent NTM organism, accounting for 54.1% (33/61) of all isolates. Behind MAC, the second most common organisms were M. abscessus (22 out of 61, 36.1%). Average rates of resistance were 4.5% for AMK, 9.1% for LZD, and 13.6% for CLA, respectively. In contrast, resistance to LEV (17/22, 77.3%), IMI (9/22, 40.9%), and SMX (10/22, 45.5%) was noted in more than 40% of M. abscessus isolates. DNA sequencing revealed that all the CLA-resistant isolates harbored nucleotide substitutions in position 2058 (1/3, 33.3%) or 2059 (2/3, 66.7%) of 23S rRNA. CONCLUSION: In conclusion, our data demonstrated that M. intracellulare and M. abscessus were the most common NTM species in the general hospital of Beijing. CLA, AMK, LZD showed promising activity, where as LEV, IMI, and SMX exhibited poor activity against M. abscessus in vitro.

Treatment strategy for the floating shoulder injury / 中国骨伤

<p><b>OBJECTIVE</b>To explore the clinical features and operative treatment of floating shoulder injuries.</p><p><b>METHODS</b>The clinical data of 25 patients with floating shoulder injuries that had been admitted to the hospital from July 2000 to May 2011 were retrospectively analyzed. There were 18 males and 7 females,wirh an average age of (36.2 +/- 2.3) years ranging from 17 to 56 years. The scapular neck fractures associated with clavicle fractures were in 21 cases and acromioclavicular joint dislocation in 4 cases. All cases were accompanied by associated injuries. Among of them, 7 cases were conservative treatment, 7 cases were fixed clavicle only, 11 cases were clavicle and scapular. All datum were rated according to Herscovici, Constant and Murley, Rowe rate system.</p><p><b>RESULTS</b>All patients were followed up for 4.6 years (range 11 months to 10 years). All fractures were healed except for 1 clavicle was delay healed. There were not infections and fixation fracture,2 of conservative treatment were dropping shoulder, 2 of 3 brachial plexus injuries were recovered 3 months later, 1 was 6 months. Suprascapular nerve injury was recoved 1 year later. Herscovici evaluation: 18 excellent, 5 good, 1 fair, 1 poor;Constant and Murley shoulder score: (83.2 +/- 5.7), pain score (12.1 + 2.5), activities of daily living score (17.2 +/- 3.2), range of motion score (32.1 +/- 3.5), strength score (18.5 +/- 2.1); Rowe evaluation: 18 excellent, 5 fair, 2 poor.</p><p><b>CONCLUSION</b>Floating shoulder injuries is high energy injury, destroy superior shoulder suspensory complex stability ,appropriate treatment should be choosen according to fractures displacement and smash level, patients' professional and anticipation</p>

Clinical outcome of surgical treatment of terrible triad of elbow / 中国骨伤

<p><b>OBJECTIVE</b>To evaluate the clinical outcome of surgical treatment of the posterior dislocation of the elbow with coroniod and radial head fractures.</p><p><b>METHODS</b>From January 2004 to March 2009, 9 patients with terrible triad of the elbow were reviewed. There were 7 males and 2 females (4 left elbows and 5 right elbows), with an average age of 41.2 years, ranged from 21 to 67 years. The radial head fractures were classified according to the Schatzker-Tile criteria: 4 patients had the fractures of type I, 3 patients had type II and 2 patients had type III. The ulnar coronoid fractures were classified according to the Regan-Morrey criteria: 2 patients had the fractures of type I, 5 patients had type II and 2 patients had type III. The general approach was used to repair the damaged structures sequentially from deep to superficial, through coronoid, anterior capsule, radial head, and lateral ligament complex to common extensor origin. If there was valgus instability in the elbow after the operation, the medial collateral ligament should be repaired with nonabsorption sutures. The plaster was applied for 7 to 10 days with elbow flexion in 90 degrees and the forearm in full pronation. Unrestricted motions and rehabilitation began at the 8th week after operation. Recovery of regular occupation depended on the degree of physical activity required, and it typically took 3 months for heavy physical laborers to return to work.</p><p><b>RESULTS</b>All the patients were followed up from 6 months to 5 years, with a mean duration of (31 +/- 6) months. At the 3rd month after operation, the mean rang of motion in flexion and extension of the elbow was (102 +/- 3) degrees (ranged from 80 degrees to 110 degrees), and the mean range of motion in pronation and supination of the forearm was (135 +/- 6) degrees (100 degrees to 150 degrees). According to the criteria of the Mayo scoreing system, the results were excellent in 5 cases, good in 3 cases, and fair in 1 case. Three patients had heterotopic ossification at the 6th month after operation. Among them, 2 patients had no effects on elbow function and were not treated, 1 patient had effects on flexion-extension of the elbow and was treated with resection of heterotopic ossification through lateral approach combined with early rehabilitation, the MEP score of the patient improved from fair to good.</p><p><b>CONCLUSION</b>The key points for treating the terrible triad of the elbow are to restore the elbow normal anatomy and early rehabilitation to avoid the elbow stiff.</p>

[Comparison of casting precision of two kinds of commercially available gypsum-bonded investment with different setting and thermal expansion characteristics].

OBJECTIVE: To investigate expansion characteristics of two kinds of commercial investment (Cristo balite Micro II and Cristo Quick), and their effects on cast accuracy of a dental Ag-Pd casting alloy. METHODS: Two kinds of investment were mixed at the ratio of 1:3. The setting and thermal expansion curves of the investment were recorded according to the requirements of ISO7490 and expansion rate calculated, respectively. Plate-like wax-patterns with pre-marked points were invested in casting rings (lined with ceramic fiber liners with thickness of 0.45 mm). Castwell M.C dental alloy were melted with gas flame and cast with a centrifugal casting machine. The differences between the castings and the wax patterns at corresponding points were calculated to represent the dimensional changes of the investment. RESULTS: The setting, thermal and total expansion rates were 0.68, 1.18, 1.86 for Cristo balite Micro II, and 0.94, 1.03, 1.97 for Cristo Quick. The setting and thermal expansion rates were statistically significant between two kinds of investment (P < 0.05), while not for the total expansion rates (P > 0.05). Effect of different investment on the precision of castings was not statistically significant (P > 0.05). CONCLUSION: Within the scope of this study, gypsum-bonded investment with similar total expansion rates but different expansion characteristics has no effect on the casting precision of Ag-Pd dental alloys.

Myocardial autophagy variation during acute myocardial infarction in rats: the effects of carvedilol.

BACKGROUND: The loss of cardiac myocytes is one of the mechanisms involved in acute myocardial infarction (AMI)-related heart failure. Autophagy is a common biological process in eukaryote cells. The relationship between cardiac myocyte loss and autophagy after AMI is still unclear. Carvedilol, a non-selective alpha1- and beta-receptor blocker, also suppresses cardiac myocyte necrosis and apoptosis induced by ischemia. However, the association between the therapeutic effects of carvedilol and autophagy is still not well understood. The aim of the present study was to establish a rat model of AMI and observe changes in autophagy in different zones of the myocardium and the effects of carvedilol on autophagy in AMI rats. METHODS: The animals were randomly assigned to a sham group, an AMI group, a chloroquine intervention group and a carvedilol group. The AMI rat model was established by ligating the left anterior descending coronary artery. The hearts were harvested at 40 minutes, 2 hours, 24 hours and 2 weeks after ligation in the AMI group, at 40 minutes in the chloroquine intervention group and at 2 weeks in other groups. Presence of autophagic vacuoles (AV) in the myocytes was observed by electron microscopy. The expression of autophagy-, anti-apoptotic- and apoptotic-related proteins, MAPLC-3, Beclin-1, Bcl-xl and Bax, were detected by immunohistochemical staining and Western blotting. RESULTS: AVs were not observed in necrotic regions of the myocardium 40 minutes after ligation of the coronary artery. A large number of AVs were found in the region bordering the infarction. Compared with the infarction region and the normal region, the formation of AV was significantly increased in the region bordering the infarction (P < 0.05). The expression of autophagy- and anti-apoptotic-related proteins was significantly increased in the region bordering the infarction. Meanwhile, the expression of apoptotic-related proteins was significantly increased in the infarction region. In the chloroquine intervention group, a large number of initiated AVs (AVis) were found in the necrotic myocardial region. At 2 weeks after AMI, AVs were frequently observed in myocardial cells in the AMI group, the carvedilol group and the sham group, and the number of AVs was significantly increased in the carvedilol group compared with both the AMI group and the sham group (P < 0.05). The expression of autophagy- and anti-apoptotic-related proteins was significantly increased in the carvedilol group compared with that in the AMI group, and the positive expression located in the infarction region and the region bordering the infarction. CONCLUSIONS: AMI induces the formation of AV in the myocardium. The expression of anti-apoptosis-related proteins increases in response to upregulation of autophagy. Carvedilol increases the formation of AVs and upregulates autophagy and anti-apoptosis of the cardiac myocytes after AMI.

Myocardial autophagy variation during acute myocardial infarction in rats: the effects of carvedilol / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The loss of cardiac myocytes is one of the mechanisms involved in acute myocardial infarction (AMI)-related heart failure. Autophagy is a common biological process in eukaryote cells. The relationship between cardiac myocyte loss and autophagy after AMI is still unclear. Carvedilol, a non-selective alpha1- and beta-receptor blocker, also suppresses cardiac myocyte necrosis and apoptosis induced by ischemia. However, the association between the therapeutic effects of carvedilol and autophagy is still not well understood. The aim of the present study was to establish a rat model of AMI and observe changes in autophagy in different zones of the myocardium and the effects of carvedilol on autophagy in AMI rats.</p><p><b>METHODS</b>The animals were randomly assigned to a sham group, an AMI group, a chloroquine intervention group and a carvedilol group. The AMI rat model was established by ligating the left anterior descending coronary artery. The hearts were harvested at 40 minutes, 2 hours, 24 hours and 2 weeks after ligation in the AMI group, at 40 minutes in the chloroquine intervention group and at 2 weeks in other groups. Presence of autophagic vacuoles (AV) in the myocytes was observed by electron microscopy. The expression of autophagy-, anti-apoptotic- and apoptotic-related proteins, MAPLC-3, Beclin-1, Bcl-xl and Bax, were detected by immunohistochemical staining and Western blotting.</p><p><b>RESULTS</b>AVs were not observed in necrotic regions of the myocardium 40 minutes after ligation of the coronary artery. A large number of AVs were found in the region bordering the infarction. Compared with the infarction region and the normal region, the formation of AV was significantly increased in the region bordering the infarction (P < 0.05). The expression of autophagy- and anti-apoptotic-related proteins was significantly increased in the region bordering the infarction. Meanwhile, the expression of apoptotic-related proteins was significantly increased in the infarction region. In the chloroquine intervention group, a large number of initiated AVs (AVis) were found in the necrotic myocardial region. At 2 weeks after AMI, AVs were frequently observed in myocardial cells in the AMI group, the carvedilol group and the sham group, and the number of AVs was significantly increased in the carvedilol group compared with both the AMI group and the sham group (P < 0.05). The expression of autophagy- and anti-apoptotic-related proteins was significantly increased in the carvedilol group compared with that in the AMI group, and the positive expression located in the infarction region and the region bordering the infarction.</p><p><b>CONCLUSIONS</b>AMI induces the formation of AV in the myocardium. The expression of anti-apoptosis-related proteins increases in response to upregulation of autophagy. Carvedilol increases the formation of AVs and upregulates autophagy and anti-apoptosis of the cardiac myocytes after AMI.</p>

[A clinical study on the extended reverse digital artery island flap].

OBJECTIVE: To investigate the feasibility and clinical effect of the extended reverse digital artery island flap including dorsal digital nerve. METHODS: Since 2001, 7 cases of pulp and digital palm defects were repaired by the extended reverse digital artery island flap including dorsal digital nerve. RESULTS: All the flaps survived. Follow-up showed satisfactory results functionally and cosmetically with 2-PD of 6-9 mm. CONCLUSIONS: The extended reverse digital artery island flap is a safe and feasible and an effective method for repair of finger pulp defects.

A clinical study on the extended reverse digital artery island flap / 中华整形外科杂志

<p><b>OBJECTIVE</b>To investigate the feasibility and clinical effect of the extended reverse digital artery island flap including dorsal digital nerve.</p><p><b>METHODS</b>Since 2001, 7 cases of pulp and digital palm defects were repaired by the extended reverse digital artery island flap including dorsal digital nerve.</p><p><b>RESULTS</b>All the flaps survived. Follow-up showed satisfactory results functionally and cosmetically with 2-PD of 6-9 mm.</p><p><b>CONCLUSIONS</b>The extended reverse digital artery island flap is a safe and feasible and an effective method for repair of finger pulp defects.</p>

Influence of piperacillin on pharmacokinetics of etimicin in healthy volunteers.

AIM: To investigate the influence of piperacillin on the pharmacokinetics of etimicin. METHODS: Ten healthy male volunteers subjects were administered randomly with 200 mg of etimicin alone or in combination with 2000 mg of piperacillin. After two weeks washout period, the subjects were crossed over to the second regimen. Blood and urinary samples were collected at specified time intervals. Etimicin concentration was analyzed using micro-bioassay method with Bacillus pumillus as the tested strain. Pharmacokinetic para-meters were determined from serum concentration-time data with the 3p87-software package. RESULTS: Maximum serum concentrations of etimicin alone was (21 +/- 5) mg/L compared with (19 +/- 4) mg/L for the combination. The elimination half-lives were (1.9 +/- 0.4) h and (1.9 +/- 0.2) h for etimicin alone and in combination, respectively. The area under the concentration-time curve of etimicin alone was (38 +/- 7) mg . h . L-1 as opposed to (41 +/- 8) mg . h . L-1 in combination. Twelve hours after administration, urinary recovery rates of etimicin were (56 +/- 8) % and (56 +/- 6) % for etimicin alone and with piperacillin, respectively. CONCLUSION: The results indicated that the pharmacokinetics of etimicin was not affected by concurrent administration of piperacillin in healthy male volunteers. No modification in dosing regimen is necessary when two drugs were co-administered.