Plastic bronchitis associated with human bocavirus 1 infection in children.

BACKGROUND: Plastic bronchitis (PB) is a clinical-pathological syndrome characterized by the abnormal accumulation of endogenous substances in the bronchial airways, causing partial or complete obstruction and resulting in impaired lung ventilation. METHODS: In this retrospective analysis, we aim to summarize the clinical manifestations, imaging characteristics, diagnostic methods, and treatment approaches to enhance clinicians' ability to detect children who are infected with human bocavirus 1 (hBoV 1) and develop PB. RESULTS: In the period from January 2021 to January 2024, a total of six hBoV 1 infection children were diagnosed with PB through bronchoscopy. The onset of the condition was mainly concentrated between June and December. The detection methods used included metagenomic next-generation sequencing for pathogen identification (three cases) and respiratory pathogen nucleic acid 13-plex detection (oropharyngeal swab) (three cases), both of which confirmed the presence of hBoV 1. Out of the six children with PB, two were girls and four were boys. Their ages ranged from 10 months to 4 years old. Common symptoms reported by all patients included fever, cough, and wheezing. Chest high-resolution computed tomography scans revealed atelectasis in six cases, in addition to pneumonia. After the removal of the plastic bronchi via bronchoscopy, the airway obstruction symptoms in the children were relieved, and no recurrence was observed during the follow-up period. Pathological findings indicated cellulose exudation and inflammatory cell infiltration, consistent with nonlymphatic PB. CONCLUSION: When children infected with hBoV 1 exhibit persistent or worsening symptoms such as cough, fever, and wheezing despite treatment, clinicians should remain highly vigilant for the potential occurrence of PB. Bronchoscopy plays a crucial role not only in diagnosing the presence of a plastic bronchus but also in effectively treating PB.

A study on ecohydrological mutual feedback relationship of the Shangdong River basin based on hydrological connectivity.

Investigating eco-hydrology in desert grasslands is pivotal to comprehend the dynamic evolution patterns of vegetation. Nonetheless, a research void persists in understanding the eco-hydrological mutual feedback mechanisms associated with hydrological connectivity and the corresponding health index evaluation of a small watershed. This study is centered on the Shangdong River watershed in Inner Mongolia and uses SWAT (Soil and Water Assessment Tool) to simulate hydrological processes. The hydrological connectivity index (IC) was employed as a link to conduct Pearson correlation analysis and Granger causality tests on ecological and meteorological-hydrological factors. Additionally, the PSR model was utilized to assess the ecological health status of the watershed. Key findings reveal the following: (1) The NDVI in the Shangdong River watershed showed an overall upward trend from 2007 to 2018, while IC exhibited an overall downward trend. Temporally and spatially, there was a significant negative correlation between IC and NDVI. (2) During the vegetation growth season, IC serves as a pivotal link in the feedback loop of eco-hydrological processes. Temperature drives vegetation growth, which in turn affects IC. IC regulates soil moisture content and evaporation, further influencing vegetation growth, thus forming a feedback mechanism. (3) Over the study period, the Grassland Health Composite Index (GHI) demonstrated a consistent rise, averaging 0.44, signaling a suboptimal state for the grassland ecosystem. Furthermore, a negative correlation was observed between GHI and IC. Consequently, regulating IC could play a crucial role in safeguarding and rejuvenating the grassland ecosystem. This study offers theoretical and data support for understanding eco-hydrological processes and effective pasture management of the desert grassland watershed.

Prussian blue analogue-derived CoP nanocubes supported on MXene toward an efficient bifunctional electrode with enhanced overall water splitting.

The exploration of bifunctional catalyst with economic, durable, and efficient performance plays a crucial role to boost both hydrogen evolution reaction (HER) and oxygen evolution reaction (OER) in overall water splitting. Herein, we report a feasible strategy to design effective heterostructure between CoP and Ti3C2Tx MXene (denoted as CoP/Ti3C2Tx). This approach allows for the growth of CoP nanoparticles with uniform size of 5 nm on the Ti3C2Tx MXene, further enhancing the water electrolysis efficiency. The CoP/Ti3C2Tx bifunctional catalyst demonstrates an exceptional HER activity with a satisfactory overpotential of 103 mV at 10 mA cm-2, and also can drive 10 mA cm-2 for OER with the overpotential of 312 mV in 1.0 M KOH. Moreover, the CoP/Ti3C2Tx-based electrolyzer exhibits high electrochemical stability for 24 h with a low required voltage of 1.66 V at 10 mA cm-2. The density functional theory (DFT) calculations reveal that the introduction of Ti3C2Tx MXene significantly adjusts d-band center towards Fermi level and expand total density of states, resulting in great electrical conductivity, enhanced water adsorption, and activation. This study provides an available mode for effective design and construction of non-noble-metal-based dual-functional catalyst toward practical energy conversion.

Optimizing concentration and interaction mechanism of Demodesmus sp. and Achromobacter pulmonis sp. consortium to evaluate their potential for dibutyl phthalate removal from synthetic wastewater.

A green approach of Desmodesmus sp. to Achromobacter pulmonis (1:1) coculture ratios was optimized to improve the removal efficiency of dibutyl phthalate (DBP) from simulated wastewater. High DBP resistance bacterial strains and microalgae was optimized from plastic contaminated water and acclimation process respectively. The influence of various factors on DBP removal performance was comprehensively investigated. Highest DBP removal 93 % was recorded, when the ratios algae-bacteria 1:1, with sodium acetate, pH-6, shaking speed-120 rpm and lighting periods L:D-12:12. Enough nutrient (TN/TP/TOC) availability and higher protein-108 mg/L and sugar-40 mg/L were observed in presences of 50 mg/L DBP. The degradation and sorption were calculated 81,12; 27,39 & 43,12 % in algae-bacteria, only algae and only bacteria system respectively. The degradation kinetics t1/2 3.74,22.15,12.86 days were evaluated, confirming that algae-bacteria effectively degrade the DBP. This outcome leading to promote a green sustainable approach to remove the emerging contamination from wastewater.

Advances of pathogenesis and drug development in amyotrophic lateral sclerosis / 中国药理学通报

Amyotrophic lateral sclerosis (ALS) is a fatal neurodegenerative disease affecting both upper and lower motor neurons. ALS patients develop progressive muscle atrophy, muscle weak and paralysis, finally died of respiratory failure. ALS is characterized by fast aggression and high mortality. What' s more, the disease is highly heterogeneous with unclear pathogenesis and lacks effective drugs for therapy. In this review, we summarize the main pathological mechanisms and the current drugs under development for ALS, which may provide a reference for the drug discovery in the future.

Surface-Enhanced Raman Spectroscopy for Boosting Electrochemical CO2 Reduction on Amorphous-Surfaced Tin Oxide Supported by MXene.

Amorphous materials disrupt the intrinsic linear scalar dependence seen in their crystalline counterparts, typically exhibiting enhanced catalytic characteristics. Nevertheless, substantial obstacles remain in terms of boosting their stability, enhancing their conductivity, and elucidating distinct catalytic mechanisms. Herein, a core-shell catalyst, comprising a crystalline SnO2 core and an amorphous SnOx shell supported on MXene (denoted as SnO2@SnOx/MXene), was prepared utilizing hydrothermal and solution reduction methods. The SnO2@SnOx/MXene catalyst excels in the electrocatalytic conversion of CO2 to formate, yielding a Faradaic efficiency (FE) as high as 93% for formate production at -1.17 V vs RHE and demonstrating exceptional durability. Both density functional theory (DFT) calculations and experimental results indicate that the SnOx shell bolsters formate formation by fine-tuning the adsorption energy of the *OCHO intermediate. In SnO2@SnOx/MXene, MXene plays a vital role in enhancing the conductivity and stability of the amorphous shell and especially amplifying Raman signals of catalyst components. The ex/in situ surface-enhanced Raman scattering (SERS) application further confirms the formation of amorphous SnOx and further enables the direct detection of the formation of the intermediate species. This work provides the basis for the application of amorphous materials in practical electrocatalytic reduction of CO2 reduction.

A signal-off photoelectrochemical sandwich-type immunosensor based on WO3/TiO2 Z-scheme heterojunction.

A sandwich "signal-off" type photoelectrochemical (PEC) immunosensor was fabricated based on a composite heterojunction of tungsten oxide/titanium oxide microspheres (WO3/TiO2) acting as signal amplification platform and carbon microspheres loaded by gold nanoparticles (Cs@Au NPs) utilized as the label for detecting antibody. WO3/TiO2 had excellent photoelectric performance, and the results of Mott-Schottky plots, open-circuit voltage, and electron spin resonance spectroscopy indicated that it belonged to the Z-scheme heterojunction transfer mechanism of photogenerated carriers. To achieve the sensitization of PEC immunosensor, Cs@Au NP-labeled immunocomplex can effectively reduce the photocurrent signal. The PEC immunosensors were fabricated under the optimal conditions of 1:1 WO3/TiO2 (molar ratio), 2.0 mg mL-1 WO3/TiO2, and 1.5 mg mL-1 Cs@Au NPs. Through comparison of the detection results of label-free and sandwich-type PEC immunosensors for nucleocapsid (N) protein of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), we found that the sensitivity of the sandwich type was 2.53 times the label-free type, and the limit of detection was 0.006 ng mL-1, i.e., 3.17 times lower than the label-free type. This demonstrates that the developed sandwich-type PEC immunosensor will have a brighter application prospect.

Hierarchical PdNi alloy nanochains coupled with Ni(OH)2 nanosheets to enhance CO-poisoning resistance for the methanol oxidation reaction.

Hybridizing Pd-based electrocatalysts with Ni-based species has been recognized as an effective pathway to enhance the catalytic performance for the methanol oxidation reaction (MOR). However, doping Ni-based species with heterogeneous valences into Pd nanocrystals still remains challenging, although heterogeneous valence Ni species may result in improved properties of Pd from different aspects. Herein, a facile one-pot synthetic method is reported to simultaneously introduce alloyed Ni0 into Pd lattices and couple hydroxy Ni2+ species with a Pd surface, generating 1D porous PdNi alloy nanochains@Ni(OH)2 nanosheet hybrids (PdNi NCs@Ni(OH)2 NSs). Borane-tert-butylamine (C4H14BN) plays the key role in realizing the formation of Ni-based species with heterogeneous valence. On one hand, it works as a reducing agent to facilitate the doping of alloyed Ni0 into the lattice of Pd nanochains. On the other hand, it raises the solution pH value and converts the remaining [Ni(CN)4]2- into Ni(OH)2 nanosheets. Each component of the PdNi NCs@Ni(OH)2 NSs plays an important role: Pd serves as the active site, alloyed Ni0 modifies the electronic structure of Pd, and Ni(OH)2 provides abundant OHads species to strengthen the anti-poisoning capability, thus greatly enhancing the activity, CO-tolerance, and durability for the MOR.

Solid Hybrid Electrolyte Featuring a Vertically Aligned Li6.4La3.0Zr1.4Ta0.6O12 Membrane for All-Solid-State Lithium Batteries.

All-solid-state lithium batteries (ASSLBs) with enhanced safety are considered one of the most promising substitutes for liquid electrolyte-based Li-ion batteries. However, many properties of solid electrolytes, such as ionic conductivity, film formability, and electrochemical, mechanical, thermal, and interfacial stability need to be improved for their practical application. In this study, a vertically aligned Li6.4La3.0Zr1.4Ta0.6O12 (LLZO) membrane with finger-like microvoids was prepared using processes involving phase inversion and sintering. A hybrid electrolyte was then obtained by infusing the LLZO membrane with a solid polymer electrolyte based on poly(ε-caprolactone). The solid hybrid electrolyte (SHE) was a flexible thin film with high ionic conductivity, superior electrochemical stability, high Li+ transference number, enhanced thermal stability, and improved Li metal electrode-solid electrolyte interfacial stability. A solid-state Li/LiNi0.78Co0.10Mn0.12O2 cell assembled with the hybrid electrolyte exhibited good cycling performance, in terms of discharge capacity, cycling stability, and rate capability. Accordingly, the SHE using a vertically aligned LLZO membrane is a promising solid electrolyte for realizing safe, high-performance ASSLBs.

A retrospective screening method for carbamate toxicant exposure based on butyrylcholinesterase adducts in human plasma with ultra-high performance liquid chromatography-tandem mass spectrometry.

Carbamate pesticides are extensively used in agriculture for their inhibition to acetylcholinesterase and damages to the insects' neural systems. Because of their toxicity, human poisoning incidents caused by carbamate pesticide exposure have occurred from time to time. What's more, some lethally toxic carbamate toxicants known as carbamate nerve agents (CMNAs) have been supplemented in Schedule 1 of the Annex on Chemicals in the Chemical Weapons Convention (CWC) by Organisation of the Prohibition of Chemical Weapons (OPCW) from 2020. And some other carbamates, like physostigmine, have been used in clinical treatment as anticholinergic drugs and their misuse may also cause damages to the body. Similar to organophosphorus toxicants, carbamate toxicants would react with butyrylcholinesterase (BChE) in plasma when entering the human body, resulting in the BChE adducts, based on which the exposure of carbamate toxicants could be detected retrospectively. In this study, methylcarbamyl nonapeptide and dimethylcarbamyl nonapeptide from pepsin digestion of BChE adducts were identified with ultra-high performance liquid chromatography-tandem mass spectrometry (UHPLC-MS/MS) in product ion scan mode. Carbofuran was chosen as the target to establish the detection method of carbamate toxicant exposure based on methylcarbamyl nonapeptide digested from methylcarbamyl BChE. Procainamide-gel affinity purification, pepsin digestion and UHPLC-MS/MS analysis in multiple reaction monitoring (MRM) mode were applied. Under the optimized conditions of sample preparation and UHPLC-MS/MS MRM analysis, the limits of detection (LODs) reached 10.0 ng/mL of plasma exposed to carbofuran with satisfactory specificity. The quantitation approach was established with d3-carbofuran-exposed plasma as the internal standard (IS) and the linearity range was 30.0-1.00 × 103 nmol/L (R2 >0.998) with the accuracy of 95.6%-107% and precision of ≤9% relative standard deviation (RSD). The applicability was also evaluated by N,N-dimethyl-carbamates with the LODs of 30.0 nmol/L for pirimicarb-exposed plasma based on dimethylcarbamyl nonapeptide. Because most of carbamate toxicants has methylcarbamyl or dimethylcarbamyl groups, this approach could be applied on the retrospective screening of carbamate toxicant exposure including CMNAs, carbamate pesticides or carbamate drugs. This study could provide an effective means in the fields of CWC verification, toxicological mechanism investigation and down-selection of potential treatment options.

Fe-Decorated Nitrogen-Doped Carbon Nanospheres as an Electrochemical Sensing Platform for the Detection of Acetaminophen.

In this work, Fe-decorated nitrogen-doped carbon nanospheres are prepared for electrochemical monitoring of acetaminophen. Via a direct pyrolysis of the melamine-formaldehyde resin spheres, the well-distributed Fe-NC spheres were obtained. The as-prepared Fe-NC possesses enhanced catalysis towards the redox of acetaminophen for abundant active sites and high-speed charge transfer. The effect of loading Fe species on the electrochemical sensing of acetaminophen is investigated in detail. The synergistic effect of nitrogen doping along with the above-mentioned properties is taken advantage of in the fabrication of electrochemical sensors for the acetaminophen determination. Based on the calibration plot, the limits of detection (LOD) were calculated to be 0.026 µM with a linear range from 0-100 µM. Additionally satisfactory repeatability, stability, and selectivity are obtained.

Double-Heterostructured Nickel Phosphate-Phosphides as High-Activity Electrocatalyst for Ammonia Borane Electrooxidation.

The direct electrooxidation reaction of ammonia borane (ABOR) as the anodic reaction of direct ammonia borane fuel cells (DABFCs) is greatly dependent on the properties of electrocatalysts. Both the active sites and charge/mass transfer characteristics are the key to promoting the processes of kinetics and thermodynamics, which can further improve the electrocatalytic activity. Hence, the catalyst double-heterostructured Ni2 P/Ni2 P2 O7 /Ni12 P5 (d-NPO/NP) with the optimistic redistribution of electrons and active sites is prepared for the first time. The d-NPO/NP-750 catalyst obtained after pyrolysis at 750 °C shows the outstanding electrocatalytic activity toward ABOR with an onset potential of -0.329 V vs RHE which is better than all the published catalysts. The density functional theory (DFT) computations illustrate that the Ni2 P2 O7 /Ni2 P acts as the activity enhancement heterostructure with a high d-band center (-1.60 eV) and the low activation energy barrier, while the Ni2 P2 O7 /Ni12 P5 acts as the conductivity enhancement heterostructure with the highest density of valence electrons.

The rapid and sensitive detection of trace copper ions by L-cysteine capped ZnS nanoparticle fluorescent probe and the insight into micro-mechanism: Experiments and DFT study.

L-cysteine (L-Cys) capped ZnS fluorescent probe (L-ZnS) were synthesized by binding ZnS nanoparticles in situ with L-Cys, the fluorescence intensity of L-ZnS increased more than 3.5 times than that of ZnS due to the cleavage of S-H bonds and the formation of Zn-S bonds between the thiol group of L-Cys and ZnS. The addition of copper ions (Cu2+) can effectively quench the fluorescence of L-ZnS to realize the rapid detection of trace Cu2+. The L-ZnS showed high sensitivity and selectivity to Cu2+. The LOD (limit of detection) of Cu2+ was as low as 7.28 nM and linearity in the concentration range of 3.5-25.5 µM. Meanwhile, for the first time, electron localization function (ELF), bond order density (BOD), and natural adaptive orbital (NAdO) analysis in the Multiwfn wavefunction program based on density functional theory were carried out to probe the binding sites and binding mode of L-Cys with Cu2+, it indicated that the deprotonated carboxyl oxygen atoms of L-Cys had the lowest electrostatic potential (ESP) and provided lone pair electrons to coordinate with Cu2+ to form non-luminescent ground state complexes, which led to fluorescence quenching of L-ZnS. From the microscopic point of view of atoms, the mechanism of fluorescence enhancement of L-Cys capped ZnS and the mechanism of fluorescence quenching after adding Cu2+ were revealed in depth, the theoretical analysis results were accordance with the experiments.

Effects of subcutaneous immunotherapy in allergic rhinitis children sensitive to dust mites

Background: Subcutaneous immunotherapy (SCIT) is now the only treatment that can modify the natural course of allergic rhinitis (AR). However, not all children with AR benefit from SCIT. Objective: To evaluate the efficacy of SCIT in dust-mites-induced AR children and explore correlative factors predicting treatment response to SCIT. Methods: 225 children aged 4–17 years old with AR were recruited from January 2016 to September 2019, and monitored at baseline, 4, 12, and 24 months after the start of SCIT treatment. The visual-analogue-score (VAS) was used to assess the clinical symptoms. Multivariate binary logistic regression analyses and receiver operating characteristic curves were used to explore correlative factors in predicting the efficacy of SCIT. Results: The significant declines in VAS started after 4 months of SCIT and continued to improve throughout the study compared with baseline. An increase in children’s age (OR=0.688, 95%CI: 0.479–0.988) and those with allergic history (OR=0.097, 95%CI: 0.009–1.095) were negatively associated with the risk of poor efficacy. Polysensitized children were more likely to suffer poor efficacy (OR=15.511 95%CI: 1.319–182.355). The clinical response at month 4 (r=0.707) and month 12 (r=0.925) was related to that at month 24. The area under the curve (AUC) for improvement at month 4 and month 12 was 0.746 and 0.860, respectively. Conclusion: Our study confirmed the clinical efficacy of SCIT in AR children. Children with younger age, negative allergic history, and multiple allergens may predict a worse efficacy. The onset of action and the clinical response to SCIT in the second year can be predicted as early as by month 4 (AU)

Sensitive fluorescent detection and micromechanism of Mn-doped CuS probe for oxytetracycline hydrochloride.

The novel CuMnS nanoflower fluorescent probe based on Mn-doped CuS was developed to achieve the fluorescence detection of oxytetracycline hydrochloride (OTC), the fluorescent sensor has good selectivity and stability. The doping of Mn significantly increased the fluorescence intensity of CuS, which was above 10 times that of CuS. When the predominant species of OTC molecule was zwitterionic OTC+/-at the solution pH of about 5.00, the fluorescence quenching efficiency of CuMnS by OTC reached the highest. Through fluorescence lifetime and UV absorption, the sensing mechanism between CuMnS and OTC was found to be static quenching. Moreover, Multiwfn wavefunction analysis program based on density function theory (DFT) calculation was applied to compare the interactions between different OTC species and CuMnS at different pH, to reveal the micromechanism of fluorescence quenching of CuMnS by OTC from the views of atoms. The molecular surface quantitative analysis and basin analysis of different OTC species demonstrated that the N atom and O atoms of tricarbonylamide moiety of zwitterionic OTC+/- can provide lone pair electrons to form a non-fluorescent ground state complex with CuMnS. Meanwhile, the electrostatic attraction of OTC+/- with negatively charged CuMnS was also beneficial to the interaction, resulting in the effective fluorescence quenching of CuMnS. This work offers a convenient method for sensitively detecting OTC and broadens the application of CuMnS in the field of fluorescence detection.

Porous carbon framework decorated with carbon nanotubes encapsulating cobalt phosphide for efficient overall water splitting.

Exploration of catalysts for water splitting is critical for advancing the development of energy conversion field, but designing bifunctional catalysts remains a major challenge. Herein, we demonstrate the N-doped carbon nanotube (NCNT)-grafted N-doped carbon (NC) framework embedding CoP nanoparticles (CoP@NC/NCNT) as hydrogen and oxygen evolution reaction (HER and OER) catalysts for water splitting. As a result, the CoP@NC/NCNT electrode requires the overpotentials of 106 and 177 mV at 10 mA cm-2 in 0.5 M H2SO4 and 1.0 M KOH solutions for HER, respectively. Moreover, an overpotential of 324 mV for OER can drive 10 mA cm-2 in 1.0 KOH. The CoP@NC/NCNT-based electrolyzer derives a current density of 10 mA cm-2 at a low voltage of 1.72 V in 1.0 M KOH and remains stable for 10 h. The outstanding electrocatalytic performance is mainly attributed to the hierarchical structure with rich branches and highly active component of CoP. The intimate contacts between hierarchical porous NC frameworks by cross-linked NCNTs create a 3D conductive network, which facilitates electron or mass transfer and activates CoP. This work offers a novel route for preparing hierarchical carbon framework encapsulated metal phosphide particles for potential applications in energy conversion field.

Effect of body mass index on pulmonary function and quality of life in elderly patients with chronic obstructive pulmonary disease / 公共卫生与预防医学

Objective To analyze the effect of body mass index (BMI) on pulmonary function and quality of life in elderly patients with chronic obstructive pulmonary disease (COPD), and to provide theoretical basis for the diagnosis and treatment of COPD. Methods A total of 1 278 patients who visited the respiratory department of our hospital from January 2019 to June 2022 were selected as the research objects, including 368 COPD patients, 225 of whom were in stable stage and 143 of whom were in acute exacerbation stage. According to BMI, they were divided into low group (n=31, BMI2), normal group (n=198,18.5kg/m2≤BMI2), overweight group (n=106, 24kg/m2≤BMI2) and obese group (n=33,BMI≥28 kg/m2). Health-related quality of life (HRQOL) was used to evaluate the quality of life of patients. Forced expiratory volume in one second (FEV1), forced vital capacity (FVC) and FEV1/FVC were measured by pulmonary function instrument to evaluate the pulmonary function grade of patients. Logistic regression was used to analyze the risk factors of pulmonary function and quality of life in COPD patients. Results There were significant differences in age, smoking, BMI and hyperlipidemia between stable COPD patients and acute exacerbation COPD patients with different BMI groups (P<0.05). There were significant differences in the proportion of pulmonary function Ⅲ/Ⅳ, FEV1/FVC, FEV1pred and HRQOL scores among different BMI groups (P<0.05) . The FEV1/FVC and FEV1pred in patients with acute exacerbation and stable COPD from high to low were obese group, overrecombination group, normal group and too low group, and the differences were statistically significant (P<0.05). The HRQOL scores of COPD patients in acute exacerbation and stable stage from high to low were obese group, overweight group, normal group and too low group, and the difference was statistically significant (P<0.05). Low body mass index was a risk factor for pulmonary function in COPD patients at stable stage (OR=2.52) and acute exacerbation stage (OR=2.83) (P<0.05). High body mass index was a risk factor for quality of life in patients with stable COPD (OR=2.43) and acute exacerbation (OR=2.65) (P<0.05). Conclusion BMI can affect pulmonary function and quality of life in COPD patients. Patients should maintain normal BMI, which can improve pulmonary function and quality of life.

Clinical characteristics and treatment of central nervous system aspergillosis: an analysis of 37 cases / 中华神经科杂志

Objective:To summarize the clinical characteristics and therapeutic efficacy of central nervous system (CNS) aspergillosis.Methods:The clinical manifestations, laboratory examination, neuroimaging features, treatment and prognosis of 37 cases of CNS aspergillosis diagnosed and treated in the First Medical Center of People′s Liberation Army General Hospital from January 2000 to January 2021 were retrospectively analyzed. According to the correlation between intracranial lesions and paranasal sinus lesions, they were divided into two groups: rhino-cerebral aspergillosis (RA, n=21) group and cerebral aspergillosis (CA, n=16) group. Results:Only 16.2% (6/37) of CNS aspergillosis patients had a clear background of immunosuppression, but 35.1% (13/37) were complicated with diabetes. The most common clinical manifestations were headache (73.0%, 27/37), cranial nerve involvement (59.5%, 22/37) and fever (37.8%, 14/37). Cerebrospinal fluid characteristics included increased pressure (53.8%, 14/26), increased white blood cell count (46.7%, 14/30), decreased glucose (30.0%, 9/30), increased protein (70.0%, 21/30), and high positive results of the metagenomic next-generation sequencing (mNGS) of pathogenic microorganism (7/10). Cranial magnetic resonance imaging showed that commonly involved sites were sinus, orbital apex, posterior orbit, cavernous sinus (43.2%, 16/37) and cerebral lobes (27.0%, 10/37). Treatment options included antifungal drugs alone (64.9%, 24/37), combination of drugs and surgery (27.0%, 10/37) and surgery alone (8.1%, 3/37). Compared with the CA group, RA group had fewer males [47.6% (10/21) vs 14/16, χ2=6.34, P=0.012] and older age [(54.2±19.4) years vs (38.4±18.4) years, t=2.50, P=0.017], and was more prone to headache [85.7% (18/21) vs 9/16, χ2=4.00, P=0.046) and cranial nerve involvement [81.0% (17/21) vs 5/16, χ 2=9.31, P=0.006]. The misdiagnosis rate of these patients in the early stage was 73.0% (27/37). A total of 29 patients (85.3%, 29/34) were treated with voriconazole successively, and the course of treatment was 3.0 (0.5, 10.4) months. Compared with salvage therapy, the mortality of primary therapy was lower (4/17 vs 9/12, χ2=7.54, P=0.006). All patients were followed up to December 2021, and 17 patients died, with a mortality rate of 45.9% (17/37). Conclusions:CNS aspergillosis may have no definite immunosuppressive background. Some of CNS aspergillosis patients are complicated with diabetes, and the clinical manifestations of the disease lack specificity, with high misdiagnosis rate in the early stage, no inflammatory changes in cerebrospinal fluid, and high positive rate of mNGS for pathogenic microorganism. Early and long-term application of voriconazole can significantly reduce the mortality rate.

Distribution characteristics of special types of diabetes mellitus in Chinese population: A literature-based analysis from 2011 to 2021 / 中华内分泌代谢杂志

Objective:To analyze the distribution characteristics of special types of diabetes in China, in order to provide a theoretical basis for the diagnosis and treatment of special types of diabetes.Methods:Pubmed, CNKI, and WanFang Data were searched for the case reports and clinical studies of special types of diabetes in China from 2011 to 2021. After independent literature screening by 2 researchers according to the inclusion and exclusion criteria, diseases and the number of corresponding cases included were extracted for statistics. The etiological composition and disease characteristics of three subtypes of special type diabetes were analyzed.Results:A total of 613 articles(7 377 patients)were included and roughly divided into eight subtypes of special type diabetes according to etiological classification for disease composition analysis. The results by ratio in descending order were as follows: mono-genetic gene defects in islet β-cell function, pancreatogenic diabetes, diabetes induced by drugs or chemicals, endocrine disease, mono-genetic gene defects in insulin action, other genetic syndromes associated with diabetes, infection, and uncommon immune-mediated diabetes. The disease composition of the three subtypes of special types of diabetes that we focused on were mono-genetic gene defects in islet β-cell function(50.21%), pancreatogenic diabetes(35.65%), and mono-genetic gene defects in insulin action(1.56%). The composition analysis of the special types of diabetes in each subtype showed that neonatal diabetes mellitus(NDM, n=1 749, 23.71%)and maturity onset diabetes in young(MODY, n=1 554, 21.07%)accounted for the largest proportions. According to the composition analysis of each subtype of MODY patients, the top three subtypes were MODY2(50.89%), MODY3(16.03%), and MODYX(8.91%). In addition, taking MODY as an example, patients with de novo mutations(DNMs)and(or)new mutation sites were summarized and analyzed. The results revealed 31 MODY patients with DNMs(1.99%) and 339 MODY patients with new mutation sites(21.81%). Conclusions:According to the literature analysis, NDM and MODY represent the largest proportion of patients with special type diabetes in China. MODY2 patients make up the largest proportion of MODY patients. In addition, diabetic patients carrying DNMs and(or)new mutation sites should be taken seriously.

Pancreatic tumors in children: diagnosis and treatment / 中华肝胆外科杂志

Objective:To study the strategies in the diagnosis and treatment of pancreatic tumors in children.Methods:The clinical data of 18 children with pancreatic tumor managed at the Children's Hospital Affiliated to Chongqing Medical University from March 2015 to September 2020 were retrospectively studied. There were 8 males and 10 females, age ranged from 3 months to 14 years and 11 months, with a median age of 8 years and 2 months. Clinical data including age, gender, pathological data, surgical methods, chemotherapy, tumor location and treatment outcomes were collected. Follow-up was conducted by outpatient visits and by telephone.Results:Abdominal ultrasound, enhanced CT and/or MRI examinations were performed on all these patients, with findings of either a cystic or solid lesion of pancreas. All patients were treated by laparotomy under endotracheal intubation and general anesthesia. The operations were all completed successfully. Among the 18 patients, there were 11 patients with solid pseudopapillary tumors and 7 patients with pancreatoblastoma (PBL). The tumors were located in the head of the pancreas in 13 patients (including 3 patients who underwent pancreaticoduodenectomy, 1 patient who underwent resection of the head of the pancreas with preservation of the duodenum, and 9 patients who underwent resection of the tumors). The tumors were located in the body and tail of the pancrease in 5 patients (including 3 patients who underwent resection of the body and tail of the pancreas with preservation of spleen, and 2 patients who underwent resection of tumors). Because of huge tumors, 1 patient had bilateral lung, left supraclavicular fossa lymph node and retroperitoneal lymph node metastasis, 3 patients were confirmed to have PBL by biopsy, and these tumors were resected completely after neoadjuvant chemotherapy. Postoperative pathology showed that all the 3 patients had PBL and were given systematic chemotherapy. Postoperative pancreatic fistula occurred in 1 patient and chylous fistula in another patient, both were discharged home successfully after conservative treatments. All patients were followed-up for 2-7 years, and all children were tumor-free.Conclusion:It is not difficult to diagnose pediatric pancreatic tumors by ultrasound, CT and MRI before operation, and postoperative pathology was needed to confirm the diagnosis. Function-preserving surgical resection was the treatment of choice for pancreatic tumors in children.