Association of preoperative coronavirus disease 2019 with mortality, respiratory morbidity and extrapulmonary complications after elective, noncardiac surgery: An observational cohort study.

STUDY OBJECTIVE: To assess the impact of preoperative infection with the contemporary strain of severe acute respiratory coronavirus 2 (SARS-CoV-2) on postoperative mortality, respiratory morbidity and extrapulmonary complications after elective, noncardiac surgery. DESIGN: An ambidirectional observational cohort study. SETTING: A tertiary and teaching hospital in Shanghai, China. PATIENTS: All adult patients (≥ 18 years of age) who underwent elective, noncardiac surgery under general anesthesia at Huashan Hospital of Fudan University from January until March 2023 were screened for eligibility. A total of 2907 patients were included. EXPOSURE: Preoperative coronavirus disease 2019 (COVID-19) positivity. MEASUREMENTS: The primary outcome was 30-day postoperative mortality. The secondary outcomes included postoperative pulmonary complications (PPCs), myocardial injury after noncardiac surgery (MINS), acute kidney injury (AKI), postoperative delirium (POD) and postoperative sleep quality. Multivariable logistic regression was used to assess the risk of postoperative mortality and morbidity imposed by preoperative COVID-19. MAIN RESULTS: The risk of 30-day postoperative mortality was not associated with preoperative COVID-19 [adjusted odds ratio (aOR), 95% confidence interval (CI): 0.40, 0.13-1.28, P = 0.123] or operation timing relative to diagnosis. Preoperative COVID-19 did not increase the risk of PPCs (aOR, 95% CI: 0.99, 0.71-1.38, P = 0.944), MINS (aOR, 95% CI: 0.54, 0.22-1.30; P = 0.168), or AKI (aOR, 95% CI: 0.34, 0.10-1.09; P = 0.070) or affect postoperative sleep quality. Patients who underwent surgery within 7 weeks after COVID-19 had increased odds of developing delirium (aOR, 95% CI: 2.26, 1.05-4.86, P = 0.036). CONCLUSIONS: Preoperative COVID-19 or timing of surgery relative to diagnosis did not confer any added risk of 30-day postoperative mortality, PPCs, MINS or AKI. However, recent COVID-19 increased the risk of POD. Perioperative brain health should be considered during preoperative risk assessment for COVID-19 survivors.

[Correlation between serum zinc and brain injury in infants with mild gastroenteritis complicated with benign infantile convulsion and febrile convulsion].

OBJECTIVE: To investigate the association between serum zinc levels and convulsive brain injury in infants with mild gastroenteritis complicated with benign infantile seizures (BICE) and febrile seizures (FC). METHODS: A case-control study method was conducted. 120 children with mild gastroenteritis and convulsion admitted to the First Affiliated Hospital of Hebei North University from January 2020 to January 2022 were enrolled as the research subjects. They were divided into BICE group and FC group according to the type of convulsion. The serum zinc level, the frequency and duration of convulsion, and the occurrence of convulsive brain injury in the two groups were recorded. Multivariate Logistic regression analysis was used to screen the risk factors for convulsive brain injury. The Spearman correlation method was used to analyze the association between serum zinc levels, clinical characteristics of convulsion and convulsive brain injury. RESULTS: A total of 120 children were enrolled, of which 81 developed to BICE and 39 developed to FC during hospitalization. The serum zinc level of children in the FC group was significantly lower than that in the BICE group (µmol/L: 39.24±6.50 vs. 48.65±7.21, P < 0.01). In the BICE group and FC group, the serum zinc level in children with more than 2 convulsions was significantly lower than that in the children with one convulsion (µmol/L: 37.65±6.50 vs. 53.17±7.55 in the BICE group, and 30.27±5.58 vs. 44.16±7.57 in the FC group, both P < 0.01). Serum zinc level in children with convulsion duration ≥ 5 minutes was significantly lower than that in the children with convulsion duration < 5 minutes (µmol/L: 38.75±6.74 vs. 51.21±7.58 in the BICE group, and 31.08±5.46 vs. 45.19±7.25 in the FC group, both P < 0.01). Moreover, the serum zinc level of children with different convulsion frequency and duration in the FC group was significantly lower than that in the BICE group (all P < 0.01). Among the 120 children, 9 cases of convulsive brain injury occurred, and the incidence rate was 7.50%. The incidence of convulsive brain injury in the BICE group was 1.23% (1/81), which was significantly lower than 20.51% in the FC group (8/39, P < 0.01). The serum zinc level of children with convulsive brain injury was significantly lower than that of children with non-brain injury (µmol/L: 28.50±5.00 vs. 60.22±7.31, P < 0.01), and the number of convulsion was significantly higher than that of non-cerebral injury (≥ 2 convulsions: 100.00% vs. 1.80%, P < 0.01), and the duration of convulsion in children with brain injury was significantly longer than that of non-brain-injured children (convulsion duration ≥ 5 minutes: 100.00% vs. 11.71%, P < 0.01). Multivariate Logistic regression analysis showed that decreased serum zinc level [odds ratio (OR) = 2.147, 95% confidence interval (95%CI) was 1.354-3.403], increased number of convulsion (OR = 3.452, 95%CI was 1.266-9.417), and prolonged convulsion duration (OR = 3.117, 95%CI was 1.326-7.327) were independent risk factor for convulsive brain injury in children with mild gastroenteritis and convulsion (all P < 0.05). Spearman correlation analysis showed that serum zinc level, convulsion ≥ 2 times, duration of convulsion ≥ 5 minutes and convulsion ≥ 2 times + convulsion duration ≥ 5 minutes were significantly negatively correlated with the occurrence of convulsive brain injury in FC children (r values were -0.546, -0.517, -0.522, and -0.528, all P < 0.01). There was no significant correlation between serum zinc level, convulsion ≥ 2 times, convulsion duration ≥ 5 minutes and convulsion ≥ 2 times+convulsion duration ≥ 5 minutes and convulsive brain injury in BICE children (r values were -0.281, -0.129, -0.201, -0.243, all P > 0.05). CONCLUSIONS: Serum zinc level is related to the characteristics of convulsive symptoms in children with mild gastroenteritis complicated with FC, and has a strong negative correlation with the occurrence of convulsive brain injury. Active targeted intervention and treatment may help reduce the incidence of brain injury in children.

Morphological Features of Fractures Developed by Direct Shearing of Intact Granites after Water Cooling Cycles.

Rock fractures are considered as favorable objects for enhanced geothermal development. The fracture morphologies play an important role in enhanced geothermal development. Therefore, the study of fracture morphologies has a certain guiding significance for the geothermal reservoir. Water cooling and water cooling cycles can change the morphology of fracture surfaces formed by the shear failure of intact granites. To date, however, there is little work on the effect of water cooling and water cooling cycles on the morphology of fracture surfaces formed by direct shearing of intact granites. In this study, the direct shear tests of intact granites treated by water cooling cycles at different temperatures were conducted, and the variations in the laws of shear strength of intact granites and morphologies of fracture surfaces with temperature or cycle times were analyzed. Test results showed that the shear strength and shear stiffness of intact granites decreased nonlinearly with the increase of temperature or cycle times, but the height and apparent dip angle of asperities on the fracture surface increased with the increase of temperature or cycle times, and the overall uniformity of the fracture surface was improved. The height distribution frequency of asperities on fracture surfaces can be divided into four types: right-biased peak type, left-biased peak type, left-biased middle peak, and left-biased flat peak. The asperities on the fracture surface formed by the shearing of intact granites have asymmetric characteristics. The maximum apparent dip angle and average apparent dip angle in the reverse shear direction are larger than those in the shear direction, and the initial contact area ratio between the shear direction and reverse shear direction is in the range of fluctuation between 1.4 and 2.

Follistatin-like I promotes endometriosis by increasing proinflammatory factors and promoting angiogenesis.

Endometriosis (EMS) is a chronic benign inflammatory disease characterized by the growth of endometrial-like tissue in aberrant locations outside of the uterine cavity. Angiogenesis and abnormal immune responses are the fundamental requirements of endometriotic lesion survival in the peritoneal cavity. Follistatin-like I (FSTL1) is a secreted glycoprotein that exhibits varied expression levels in cardiovascular disease, cancer and arthritis. However, the role of FSTL1 in the development of EMS remains to be fully elucidated. Results of the present study demonstrated that the expression of FSTL1 was significantly increased in ectopic endometrial stromal cells (ESCs) and peritoneal fluid from patients with EMS, compared to the control group. Both conditions of hypoxia and estrogen treatment induced human ESCs to produce increased levels of FSTL1 and disco-interacting protein 2 homolog A (DIP2A). Furthermore, the expression levels of DIP2A, IL8 and IL1ß were increased in FSTL1 overexpressed HESCs. Additionally, FSTL1 treatment increased the proliferation of HUVECs in a dose-dependent manner in vitro and markedly increased the tube formation of HUVECs. Moreover, treatment with FSTL1 facilitated M1 polarization of macrophages, increased the secretion of proinflammatory factors and inhibited the expression of scavenger receptor CD36. Results of the present study suggested that the elevated expression of FSTL1 may play a key role in accelerating the development of EMS via enhancing the secretion of proinflammatory factors and promoting angiogenesis.

Comparative analysis of gut microbiota diversity in endangered, economical, and common freshwater mussels using 16S rRNA gene sequencing.

Freshwater mussels are both among the most diverse and endangered faunas worldwide. The gut microbiota of species plays a key role in nutrition and immunity, such as preventing it from pathogen invasion, synthesizing beneficial secondary metabolites, and contributing to the digestion of complex nutrients. Information on the gut microbiota could have significant implications for conservation biology, especially for threatened or endangered species. However, there is relatively little study into the gut microbiota of freshwater mussels. Here, the gut microbiota diversity was analyzed in endangered (Solenaia carinata), economical (Sinohyriopsis cumingii), and common (Sinanodonta woodiana) freshwater mussels using 16S rRNA gene sequencing. This study represents the first to compare the gut microbiota diversity of endangered, economical, and common Chinese freshwater mussels. The results showed that 13,535 OTUs were found in S. carinata, 12,985 OTUs in S. cumingii, and 9,365 OTUs in S. woodiana. The dominant phylum in S. carinata and S. cumingii was Fusobacteria, and was Firmicutes in S. woodiana. Alpha diversity indices indicated that S. carinata and S. cumingii had a higher abundance and diversity of gut microbiota than S. woodiana. The composition of gut microbiota was different among three freshwater mussels, but their composition variation was not significant. This study provides insight for the conservation of freshwater mussel biodiversity, which will not only help conserve these vulnerable groups but also, will offer wider benefits to freshwater ecosystems.

Long non-coding RNA PRNCR1 modulates non-small cell lung cancer cell proliferation, apoptosis, migration, invasion, and EMT through PRNCR1/miR-126-5p/MTDH axis.

BACKGROUND: Non-small cell lung cancer (NSCLC) is a highly malignant tumor. Accumulating evidence suggested that prostate cancer non-coding RNA 1 (PRNCR1) participated in the pathogenesis of NSCLC, whereas the elaborate mechanism remains unclear. Hence, the role of PRNCR1 in the progression of NSCLC was investigated. METHODS: Levels of PRNCR1, microRNA-126-5p (miR-126-5p), and metadherin (MTDH) were examined by quantitative real-time polymerase chain reaction (qRT-PCR). Cell proliferation was measured using Cell Counting Kit-8 (CCK-8). Flow cytometry was conducted to determine cell apoptosis. Besides, transwell assay was performed to detect cell migration and invasion in NSCLC cells. The expression levels of E-cadherin, N-cadherin, Vimentin, and MTDH were detected via Western blot. Dual-luciferase reporter, RNA immunoprecipitation, and RNA pull down assays were employed to verify the relationship between miR-126-5p and PRNCR1 or MTDH. RESULTS: PRNCR1 and MTDH levels were highly expressed, while miR-126-5p expression was lowly expressed in NSCLC tissues and cell lines. Knockdown of PRNCR1 promoted cell apoptosis, impeded proliferation, migration, invasion, and epithelial-mesenchymal transition (EMT) in NSCLC cells, and these effects were abrogated by its target gene of miR-126-5p inhibitor. Moreover, MTDH as the target of PRNCR1, its overexpression reversed the impacts of miR-126-5p mimic on cell behaviors and EMT in vitro. Finally, PRNCR1 and miR-126-5p regulated MTDH expression. CONCLUSION: PRNCR1 modified cell behaviors and EMT via miR-126-5p/MTDH axis in NSCLC cells, providing a novel thinking for clinical treatment of NSCLC.

Do endometrial lesions require removal? A retrospective study.

BACKGROUND: This study aimed to evaluate the management of asymptomatic intrauterine lesions detected by ultrasonography. METHODS: Patients who underwent diagnostic hysteroscopy for asymptomatic lesions, including pre- and post-menopausal endometrial polyps, post-menopausal endometrial thickening (ET ≥5 mm) and reduplicative endometrial heterogeneity detected by transvaginal ultrasonography (TVUS), were recruited for this study. RESULTS: In the 792 recruited patients, the symptom-free focal masses within the uterine cavity detected by TVUS included 558 patients with pre- or post-menopausal endometrial polyps and 234 patients with postmenopausal endometrial thickening. No pre-menopausal patient presented with carcinoma. The polyp diameter (PD) was not identified as an independent risk factor for malignancy in this study. A significant difference (P = 0.036, < 0.05) in both benign and malignant endometrial lesions was observed between two groups of post-menopausal women stratified using an endometrial thickness cut-off of ≥11 mm. The TVUS was highly sensitive (94%) for pre-menopausal polyps. This technique had a specificity and positive predictive value of 84.4 and 92.7%, respectively, for postmenopausal polyps. The TVUS was clearly valuable for ruling out polyps, as indicated by a negative likelihood ratio (LR-) of 0.087. Among postmenopausal women with endometrial thickening, the area under the receiver operating characteristic curve was 0.828 (P < 0.001). An ET cut-off value of 12.5 mm yielded a sensitivity of 72.7% and specificity of 86%. CONCLUSION: We recommend follow-up alone for women with asymptomatic uterine polyps, particularly those who are pre-menopausal. Additionally, gynaecologists should consider risk factors such as age, obesity, polycystic ovarian syndrome, and diabetes. Prospective long-term follow-up studies should be conducted after hysteroscopic polypectomy to evaluate the recurrence rate of endometrial lesions.

H2S promotes proliferation of endometrial stromal cells via activating the NF-κB pathway in endometriosis.

Hydrogen sulfide (H2S) is substantially converted from cysteine by the enzymes cystathionine ß-synthase (CBS) and cystathionine γ-lyase (CSE). H2S can profoundly affect most organ systems in animals and humans by inducing a wide range of physiological functions. However, the roles of H2S in the progression of endometriosis remain unknown. The aim of the current study was to test the hypothesis that H2S might play a role in the pathogenesis of endometriosis via modulating the biological behavior of endometrial stromal cells (ESCs). First, we explored the expression level of CBS and CSE in ESCs via immunohistochemistry and immunocytochemistry. Second, cell Count Kit-8 (CCK-8) assays were utilized to investigate the cell viability of human ESCs (HESCs) in vitro. Third, we studied the potential effects of H2S in a rodent model of endometriosis. Both CBS and CSE were overexpressed in endometriotic lesions. Exogenous and endogenous H2S could promote HESC proliferation in vitro. Furthermore, this pro-proliferation effect could be reversed by treating with inhibitors of CBS, CSE, or the NF-κB pathway. In vivo, we uncovered that inhibitors of CBS and CSE could remarkably reduce the number and weight of mouse endometriotic lesions. These data suggested that H2S promotes ESC proliferation via activation of the NF-κB pathway, which provides a scientific basis for the clinical application of blocking H2S to treat endometriosis.

Genetic structure and diversity of Nodularia douglasiae (Bivalvia: Unionida) from the middle and lower Yangtze River drainage.

The Yangtze River drainage in China is among the most species rich rivers for freshwater mussels (order Unionida) on Earth with at least 68 species known. The freshwater mussels of the Yangtze River face a variety of threats with indications that species are declining in abundance and area of occupancy. This study represents the first analyses of the genetic structure and diversity for the common and widespread freshwater mussel Nodularia douglasiae based on microsatellite DNA genotypes and mitochondrial DNA sequences. Phylogenetic analysis a fragment of the COI mitochondrial gene indicated that N. douglasiae collected from across the middle and lower Yangtze River drainage are monophyletic with N. douglasiae from Japan, Russia, and South Korea. The results of the analysis of both the mtDNA and microsatellite datasets indicated that the seven collection locations of N. douglasiae in the middle and lower Yangtze River drainage showed high genetic diversity, significant genetic differentiation and genetic structure, and stable population dynamics over time. Moreover, we found that the connections among tributaries rivers and lakes in the Yangtze River drainage were important in maintaining gene flow among locations that N. douglasiae inhabits. An understanding of the genetic structure and diversity of a widespread species like N. douglasiae could be used as a surrogate to better understand the populations of other freshwater mussel species that are more rare in the Yangtze River drainage. At the same time, these results could provide a basis for the protection of genetic diversity and management of unionid mussels diversity and other aquatic organisms in the system.

Pharmacokinetics, metabolism, and excretion of cycloastragenol, a potent telomerase activator in rats.

1. The objective of this study was to investigate the pharmacokinetics, excretion, and metabolic fate of cycloastragenol (CA) in rats. 2. An LC-MS method was developed and used to quantify CA in biological samples. Rats were orally administrated with CA at 10, 20, and 40 mg/kg or intravenously administrated at 10 mg/kg to determine pharmacokinetic parameters of CA. For excretion experiment, urine, feces, and bile were collected at 24 h after oral administration (40 mg/kg), also at 12 h after intravenous administration (10 mg/kg). An LC-MS/MS method was developed to identify the metabolites of CA. 3. The results showed that the oral bioavailability of CA was about 25.70% at 10 mg/kg. CA was excreted through bile and feces and eliminated predominantly by the kidney in rats. It also might exist an enterohepatic circulation of CA in rats. CA could be metabolized widely in vivo in rat, seven, six, and one phase I metabolites were found in feces, urine, and bile samples respectively, but no phase II metabolite was found. 4. In summary, this study defined pharmacokinetics characteristics of CA, described its excretion, and established its in vivo metabolism in rats.

Electrical control of memristance and magnetoresistance in oxide magnetic tunnel junctions.

Electric-field control of magnetic and transport properties of magnetic tunnel junctions has promising applications in spintronics. Here, we experimentally demonstrate a reversible electrical manipulation of memristance, magnetoresistance, and exchange bias in Co/CoO-ZnO/Co magnetic tunnel junctions, which enables the realization of four nonvolatile resistance states. Moreover, greatly enhanced tunneling magnetoresistance of 68% was observed due to the enhanced spin polarization of the bottom Co/CoO interface. The ab initio calculations further indicate that the spin polarization of the Co/CoO interface is as high as 73% near the Fermi level and plenty of oxygen vacancies can induce metal-insulator transition of the CoO(1-v) layer. Thus, the electrical manipulation mechanism on the memristance, magnetoresistance and exchange bias can be attributed to the electric-field-driven migration of oxygen ions/vacancies between very thin CoO and ZnO layers.

Spin memristive magnetic tunnel junctions with CoO-ZnO nano composite barrier.

The spin memristive devices combining memristance and tunneling magnetoresistance have promising applications in multibit nonvolatile data storage and artificial neuronal computing. However, it is a great challenge for simultaneous realization of large memristance and magnetoresistance in one nanoscale junction, because it is very hard to find a proper spacer layer which not only serves as good insulating layer for tunneling magnetoresistance but also easily switches between high and low resistance states under electrical field. Here we firstly propose to use nanon composite barrier layers of CoO-ZnO to fabricate the spin memristive Co/CoO-ZnO/Co magnetic tunnel junctions. The bipolar resistance switching ratio is high up to 90, and the TMR ratio of the high resistance state gets to 8% at room temperature, which leads to three resistance states. The bipolar resistance switching is explained by the metal-insulator transition of CoO(1-v) layer due to the migration of oxygen ions between CoO(1-v) and ZnO(1-v).

Enhanced T cell-independent antibody responses in c-Jun N-terminal kinase 2 (JNK2)-deficient B cells following stimulation with CpG-1826 and anti-IgM.

Although c-Jun NH2-terminal kinase (JNK) 1 and JNK2 have been demonstrated to modulate T cell activation, role of JNKs in B cell activation remains largely unclear. Phosphorylation of JNK2 was increased in murine B cells following stimulation with either anti-IgM or CpG-1826 oligonucleotide (ODN) alone, with a further increase by a combined stimulation with anti-IgM and CpG-1826 ODN. In this study, we examined whether antibody production induced by CpG ODN and/or anti-IgM is affected in B cells from JNK2-deficient (JNK2-/-) mice. After stimulation with CpG ODN or both CpG ODN and anti-IgM, JNK2-/- B cells displayed an enhanced antibody production of IgG1 and IgG2a, with less pronounced in IgG2b production, as assessed by enzyme-linked immunoassay (ELISA). However, IgM production in JNK2-/- B cells by CpG ODN was comparable to that in WT B cells. TLR9 expression was increased in JNK2-/- B cells after stimulation with anti-IgM or both CpG ODN and anti-IgM, suggesting that the anti-IgM/CpG ODN-induced enhancement of antibody production is partly due to the increased expression of TLR9. The enhanced antibody production in JNK2-/- B cells by the combined stimulation does not appear to involve either increased class switch recombination or cell proliferation. Our results provide useful information on the role of JNK2 in antibody responses mediated by T cell-independent antigens.

Improvement of amplified spontaneous emission by encapsulating green fluorescent dye in inverted-opal titania photonic crystals.

Amplified spontaneous emission (ASE) characteristics of a green fluorescent dye (10-(2-benzothiazolyl)-1,1,7,7-tetramethyl-2,3,6,7-tetrahydro-1H,5H,11H-[1] benzo- pyrano [6,7,8-ij]quinolizin-11-one) (C545T) encapsulated in a highly ordered three-dimensional (3D) inverted-opal titania (TiO(2)) photonic crystal (PC) microcavity were studied. Due to the utilization of a TiO(2) PC, the emission spectrum was greatly narrowed and the ASE threshold, gain, and loss were significantly improved. The threshold, gain, and loss reached 1.25 mJ pulse(-1) cm(-2), 34.69 cm(-1), and 16.9 cm(-1), respectively. The possible reason for the improvement in the ASE performance by the PC is attributed to the 3D photon localization by the microcavity effect of the PC.

Synthesis and photonic band calculations of NCP face-centered cubic photonic crystals of TiO2 hollow spheres.

With the help of self-assembly, thermal sintering, selective etching techniques and sol-gel process, the non-close packed (ncp) face-centered cubic (fcc) photonic crystals of titanium dioxide (TiO2) hollow spheres connected by TiO2 cylindrical tubes have been fabricated using silica template. The photonic bandgap calculations indicate that the ncp structure of TiO2 hollow spheres was easier to open the pseudogaps than close packed system at the lowest energy.