The youngest infant with COVID-19-associated necrotizing encephalitis in Asia: A case report.

Acute necrotic encephalopathy in children is a very rare complication of severe acute respiratory syndrome coronavirus 2 infection and has rarely been reported worldwide. A 45-day-old girl was admitted to our hospital with fever and listlessness. A nose swab tested positive for the novel coronavirus nucleic acid, and her cerebrospinal fluid was positive for severe acute respiratory syndrome coronavirus 2. An early head magnetic resonance imaging scan indicated multiple abnormal signals in her bilateral cerebral hemispheres, and encephalitis was diagnosed. Twenty-three days after hospitalization, bilateral cerebral atrophy-like changes were observed on magnetic resonance imaging, with multiple softening lesions in the bilateral cerebral hemispheres, accompanied by convulsions. She was admitted to the hospital for mechanically assisted ventilation, and her condition improved after treatment of her symptoms with antiepileptic medication, anti-infection drugs, glucocorticoids, and immunoglobulins. Acute necrotic encephalopathy associated with severe acute respiratory syndrome coronavirus 2 infection in children should be detected and treated as early as possible. Satisfactory short-term efficacy can be obtained, but long-term neurological sequelae often linger.

Efficacy of Adjuvant Transarterial Chemoembolization Combined Antiviral Therapy for HBV-Related HCC with MVI after Hepatic Resection: A Multicenter Study.

BACKGROUND: Efficacy of transarterial chemoembolization (TACE) combined antiviral therapy (AVT) on long-term outcome in hepatitis B virus-related HCC with microvascular invasion (MVI) after hepatic resection is unclear. METHODS: A multicenter retrospective study was conducted. All patients were divided into four groups according to postoperative adjuvant therapy (control group, AVT group, TACE group, and combined group). The overall survival (OS) and recurrence-free survival (RFS) were analyzed. RESULTS: A total of 1090 patients were enrolled in this study, including control group (n=319), TACE group (n=152), AVT group (n=335) and combined group (n=284). Multivariate Cox analysis showed that postoperative adjuvant AVT and TACE were the independent protective factors for OS and RFS. The median OS among the control group, TACE group, AVT group, and the combined group were 16.44, 18.36 months, 38.88 months, and 48.24 months respectively(p<0.01). The median RFS among 4 group were 4.68, 5.40 months, 8.64 months and 10.32 months respectively(p<0.01). CONCLUSIONS: Postoperative adjuvant TACE and AVT were the independent protective factors associated with mortality and tumor recurrence in HBV-related HCC with MVI after resection. This combined treatment strategy may provide useful clinical significance in the prevention of tumor recurrence in these patients.

High expression of microRNA-1266 in hepatocellular carcinoma is associated with poor prognosis of patients and biological cell growth.

Hepatocellular carcinoma (HCC) is a cancer with a poor prognosis and a low survival rate. Previous studies have found that microRNA-1266 (miR-1266) is associated with tumorigenesis and progression of several types of cancer, such as breast cancer and gastric cancer. The aim of the present study was to investigate the effects of miR-1266 on the clinical prognosis and biological behavior of HCC. For this purpose, reverse transcription-quantitative PCR was used to detect the expression of miR-1266 in HCC tissues and HCC cell lines. In addition, Kaplan-Meier survival analysis and Cox regression analysis were used to evaluate the prognostic value of miR-1266. Cell Counting Kit-8 (CCK-8) and Transwell assays were used to analyze the effect of miR-1266 on the biological behavior of cells. The aforementioned assays demonstrated that the examined HCC tissues had a significant upregulation of miR-1266 expression compared with normal tissues (P<0.001). The overexpression of miR-1266 was significantly associated with Tumor-Node-Metastasis stage (P=0.014). The results of the Kaplan-Meier analysis indicated that the 5-year overall survival rate of patients with high expression of miR-1266 was significantly lower compared with patients with low expression of miR-1266 (P=0.015). Cox regression analysis demonstrated that the expression level of miR-1266 could be used as an independent prognostic factor of HCC. CCK-8 and Transwell assays demonstrated that overexpression of miR-1266 promoted the proliferation, migration and invasion of HCC cells. In summary, the findings of the present study indicated that high expression of miR-1266 was positively associated with poor prognosis of patients with HCC and promoted cell proliferation, migration and invasion of HCC cells. miR-1266 may be used as a biomarker for HCC prognosis.

A flexible assay strategy for non-glucose targets based on sulfhydryl-terminated liposomes combined with personal glucometer.

The personal glucose meter (PGM) is one of the most successful point-of-care (POC) testing devices. It is simple, robust and inexpensive, but cannot be easily adapted to analytes other than glucose. We report a novel chemical conjugation-based assay strategy, using rational design of chemically-derivatized glucose-encapsulating liposomes, to repurpose a PGM, taking an important mycotoxin patulin as the model analyte. Sulfhydryl (-SH) was proposed for the first time as a specific functional group for efficient recognition of patulin. Multifunctional sulfhydryl-terminated glucose-encapsulating liposomes (G-LIP-SH) were synthesized in a simple, single step, which efficiently captured patulin by covalent bonding, and interacted strongly with NH2-Au@Fe3O4 nanoparticles. Magnetic removal of nanoparticles efficiently and selectively separated patulin-derivatized from un-derivatized G-LIP-SH, permitting the latter to be lysed and the released glucose measured by PGM. The PGM signal was inversely proportional to the patulin concentration, over the range of 0.1-50 ng mL-1 (R2 = 0.995) with a detection limit of 0.05 ng mL-1 (S/N = 3). This approach overcame interference from endogenous glucose, other mycotoxins and metal ions, allowing the analysis of a wide range of sample matrices and showed high specificity, acceptable reproducibility, good accuracy and optimal applicability. Other derivatization chemistries will enable this approach to be adapted to analytes with a wide range of chemical structures, to facilitate development of rapid, portable, user-friendly and cost-effective assays applicable to diverse analytes and sample matrices.

[Effect of early continuous blood purification on the prognosis of children with septic shock: a prospective randomized controlled clinical trial].

OBJECTIVE: To study the effect of early continuous blood purification (CBP) on the prognosis of children with septic shock. METHODS: A prospective analysis was performed for the children with septic shock who did not reach the 6-hour initial recovery target and/or had a fluid overload of >10%. According to the treatment time of CBP, they were divided into an early group with 30 children and a conventional group with 28 children. The two groups were compared in terms of the start time of CBP and 28-day mortality rate, as well as the related indexes in the children who were cured. RESULTS: The early group had a significantly earlier start time of CBP than the conventional group (P<0.05). There were 25 children cured in the early group and 22 cured in the conventional group, and there was no significant difference in 28-day mortality rate between the two groups (P>0.05). The children who were cured in the early group had significantly shorter correction time of lactic acid, urine volume, and fluid overload than those in the conventional group (P<0.05). The children who were cured in both groups had significant reductions in the percentages of T-lymphocyte subsets at the beginning (P<0.05); on reexamination on day 7, the percentages of T-lymphocyte subsets were increased and were higher in the early group than in the conventional group (P<0.05). The children who were cured in the early group had significantly shorter duration of CBP treatment, duration of mechanical ventilation, and length of stay in the PICU than those in the conventional group (P<0.05). CONCLUSIONS: For children with septic shock who do not reach the 6-hour initial recovery target and/or have a fluid overload of >10%, early CBP treatment can quickly control the disease, shorten the course of disease, and accelerate immune reconstruction.

Safety and feasibility of laparoscopy technology in right hemihepatectomy.

Laparoscopic hepatectomy (LH) has been accepted widely owing to its advantages as a minimally invasive surgery; however, laparoscopic right hemihepatectomy (LRH) has rarely been reported. We aimed to compare the benefits and drawbacks of LRH and open approaches. Between January 2014 and October 2017, 85 patients with tumor and hepatolithiasis who underwent LRH (n = 30) and open right hemihepatectomy (ORH) (n = 55) were enrolled in this study. For tumors, LRH showed significantly better results with respect to blood loss (P = 0.024) and duration of hospital stay (P = 0.008) than ORH, while hospital expenses (P = 0.031) and bile leakage rate (P = 0.012) were higher with LRH. However, the operative time and rate of other complications were not significantly different between the two groups. However, for hepatolithiasis, there was less blood loss (P = 0.015) and longer operative time (P = 0.036) with LRH than with ORH. There were no significant difference between LRH and ORH in terms of hospital stay, hospital expenses, and complication rate (P > 0.05). Moreover, the postoperative white blood cell count, alanine aminotransferase level, aspartate aminotransferase level, and total bilirubin were not significantly different in both types of patients (P > 0.05). Our results suggest the safety and feasibility of laparoscopy technology for right hemihepatectomy in both tumor and hepatolithiasis patients.