Effect of low high-density lipoprotein levels on mortality of septic patients: A systematic review and meta-analysis of cohort studies

BACKGROUND:An increase in high-density lipoprotein(HDL)is well associated with a decreased cardiovascular risk,especially atherosclerosis.Recent studies suggest that lower levels of HDL may also be associated with an increased risk of sepsis and an increased rate of mortality in septic patients.However,this conclusion remains controversial.METHODS:MEDLINE,EMBASE,and CENTRAL databases were searched from inception to September 30,2019.All studies were conducted to evaluate the correlation of lipoprotein levels and the risk and outcomes of sepsis in adult patients.The primary outcomes were the risk and mortality of sepsis.RESULTS:Seven studies comprising 791 patients were included.Lower levels of HDL had no marked relevance with the risk of sepsis(odds radio[OR]for each 1 mg/dL increase,0.94;95%CI 0.86–1.02;P=0.078),whereas lower HDL levels were related to an increased mortality rate in septic patients(OR for below about median HDL levels,2.00;95%CI 1.23–3.24;P=0.005).CONCLUSION:This meta-analysis did not reveal a signifi cant association between lower HDL levels and an increase in the risk of sepsis,whereas it showed that lower HDL levels are associated with a higher mortality rate in septic adult patients.These findings suggest that HDL may be considered as a promising factor for the prevention and treatment of sepsis in the future.     

建立下肢形态学数据库为匹配术后即装假肢提供参考

文题释义： 术后假肢：现代截肢康复的方法包括手术后安装临时假体，即在完成截肢手术后，医生为患者佩戴合适的临时假体。 大腿影像数据：研究采集的大腿数据包括膝上缘周径、膝上缘5 cm处周径、膝上缘10 cm处周径和膝上缘15 cm处周径，将大腿MRI数据导入3D重建软件，得到大腿截肢范围段表面积、体积。 大腿截肢范围段：为膝关节间隙上10-25 cm。 背景：目前假肢的制作是通过取型、修型、成型3个步骤完成的，由于修型过程是人工完成，与临床技师的经验技术密切相关，制作出来的假肢不美观，接受腔与残肢很难做到全接触。 目的：收集健康志愿者大腿MRI影像数据，评估成人大腿截肢范围段(膝关节间隙上10-25 cm)的对称性；将MRI影像数据建立成数据库，为下肢截肢患者匹配合适的术后即装假肢提供参考数据。 方法：招募40名健康志愿者，采集基本信息：年龄、身高、体质量、膝上缘周径、膝上缘5 cm处周径、膝上缘10 cm处周径和膝上缘15 cm处周径。所有志愿者对试验方案均知情同意，且得到医院伦理委员会批准。对大腿截肢范围进行三维重建，以模型的表面积、体积为参数，对每一例志愿者大腿进行解剖测量，利用三维逆向工程软件对测量结果进行3D偏差分析，完成大腿形态对称性的定量化和可视化分析。 结果与结论：①同体分析：同一个体左右大腿截肢范围段表面积之间的最大百分差异比不超过0.56%(P=0.109)；左右大腿截肢范围段体积之间最大百分差异比不超过1.19%(P=0.182)；三维偏差分析结果显示，最大平均负偏差为-1.47 mm，最大平均正偏差为1.14 mm。40例受试者的3D偏差分布78.02%在2 mm以内，20.97%在2.1-3.0 mm，仅1.01%大于3 mm。②异体分析：三维偏差分析结果显示，最大平均负偏差为-1.97 mm，而最大平均正偏差为1.89 mm。③提示成人双侧大腿截肢范围具有高度的解剖学对称性；当2名成人的膝上缘周径、膝上缘5 cm处周径、膝上缘10 cm周径和膝上缘15 cm处周径分别都相差在2 cm以内时，则认为这2名成人双侧大腿截肢范围段表面轮廓具有高度相似性，与性别、身高和体质量无关。 ORCID: 0000-0001-6838-3042(伍笑棋) 中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程     

妊娠晚期危重型新型冠状病毒肺炎一例

本文报告一例妊娠晚期合并新型冠状病毒肺炎(COVID-19)危重型孕妇。患者32岁,孕35周+2因"咽痛4 d,发热3 h"入院。入院前曾至湖北孝感应城,回家隔离期间发病。入院后病情进展迅速,7 h后出现左侧胸背部疼痛、气促、头晕,迅即出现呼吸衰竭、感染性休克。考虑病情严重,且有2次剖宫产史,行紧急子宫下段剖宫产术。术前血气分析示呼吸衰竭、呼吸性酸中毒合并代谢性酸中毒。术中娩出一男婴,2700 g,1 min Apgar评分1分(心率20次/min),经复苏抢救,5和10 min评分均为1分,家属放弃抢救后死亡。产妇术后气管插管呼吸机维持,同时给予其他支持治疗。入院时的新型冠状病毒核酸检测结果于分娩后报告为阳性,遂转入定点医院治疗。患者术后26 d体外膜肺氧合脱机成功,术后36 d脱离呼吸机,进入康复阶段。     

Controlled Growth of Polyamide Films atop Homogenous and Heterogeneous Hydrogels Using Gel–Liquid Interfacial Polymerization

Controlled growth of crosslinked polyamide (PA) thin films is demonstrated at the interface of a monomer‐soaked hydrogel and an organic solution of the complementary monomer. Termed gel–liquid interfacial polymerization (GLIP), the resulting PA films are measured to be chemically and mechanically analogous to the active layer in thin film composite (TFC) membranes. PA thin films are prepared using the GLIP process on both a morphologically homogeneous hydrogel prepared from poly(2‐hydroxyethylmethacrylate) and a phase‐separated, heterogeneous hydrogel prepared from poly(acrylamide). Two monomer systems are examined: trimesoyl chloride (TMC) reacting with m‐phenylene diamine (MPD) and TMC reacting with piperazine (PIP). Unlike the self‐limiting growth behavior in TFC membrane fabrication, diffusion‐limited, continuous growth of the PA films is observed, where both the thickness and roughness of the PA layers increase with reaction time. A key morphological difference is found between the two monomer systems using the GLIP process; TMC/MPD produces a ridge‐and‐valley surface morphology whereas TMC/PIP produces nodule/granular structures. The GLIP process represents a unique opportunity to not only explore the pore characteristics (size, spacing, and continuity) on the resulting structure and morphology of the interfacially polymerized thin films, but also a method to modify the surface of (or encapsulate) hydrogels.     

Skewed B cell receptor repertoire and reduced antibody avidity in patients with DOCK8 deficiency

DOCK8 immunodeficiency syndrome (DIDS) is a combined immunodeficiency characterized by recurrent viral infections, severe atopy and early onset malignancy. Immunological abnormalities include lymphopenia, CD8⁺ T‐cell cytoskeleton dysfunction, defective B cell memory and variable serum immunoglobulin levels. Here, we analyse the B cell receptor repertoire (BCR) characteristics and antibody avidity of four DIDS patients, attempt to understand the dysregulated humoral immunity in DIDS patients with a normal antibody titre and suggest a scientific basis for intravenous immunoglobulin (IVIG) replacement therapy for these patients. We analysed BCR characteristics, including somatic hypermutation (SHM) frequency, using deep sequencing of multiplex PCR products derived from BCR heavy chain CDR3 regions from DIDS patients and controls. The antibody avidity of human tetanus and hemophilus influenza B antibodies was determined by ELISA using thiocyanate elution. IVIG replacement treatment and infection conditions were investigated retrospectively. We found skewing of the BCR repertoire and decreased antibody avidity in patients with DIDS. DIDS patients had fewer negatively charged amino acids than healthy controls. The SHM frequency of the IGHV3 gene was lower in patients with DIDS. Patients received regular IVIG therapy, resulting in fewer and less severe infections. We conclude that although IgG levels are normal in most DIDS patients, IVIG replacement therapy is still necessary.     

Prevalence and genetic diversity of human sapovirus associated with sporadic acute gastroenteritis in South China from 2013 to 2017

Human sapovirus (SaV) is an important viral agent for acute diarrhea worldwide, but timely prevalence data of human SaV in South China are still lacking. In this study, a 4-year surveillance was conducted to characterize the prevalence and genetic characteristics of the circulating SaV associated with sporadic diarrhea in South China. From November 2013 to October 2017, 569 fecal samples from patients with acute diarrhea were collected. SaV was detected in 11 samples with a positive rate of 1.93%. Three human genogroups of GI, GII, and GIV were identified, including five GI.1 strains, three GI.2 strains, one GI.3 strain, one GII.8 strain, and one GIV strain. Furthermore, multiple alignments of complete capsid protein VP1 genes of five local GI.1 strains and other available GI.1 strains in GenBank were performed. Average pairwise identities were calculated at 95.33% and 99.36% at nucleotide and amino acid levels, and only six variable amino acid sites were found during its 36-years’ evolution process. GI.1 strains could be further phylogenetically divided into four clusters with an approximate temporal evolution pattern, and local strains belonged to Cluster-d with other four strains from China and Japan. In summary, SaV was identified as an etiological agent responsible for sporadic gastroenteritis in Guangzhou with a low prevalence rate as in other Chinese cities, but its high genetic diversity suggested the necessity of continuous SaV surveillance in the future.     

猪尾巴导管在单孔胸腔镜肺肿瘤手术中应用的有效性评估:基于倾向性评分匹配法的研究

目的评估猪尾巴导管在单孔胸腔镜肺肿瘤手术中应用的有效性。方法回顾性分析2020年1月至12月上海交通大学医学院附属仁济医院东院接受单孔胸腔镜肺肿瘤手术的患者共441例,根据是否放置猪尾巴导管分为胸管组和猪尾巴管组,通过倾向性评分匹配法进行1∶1匹配,对比两组患者围手术期的各项指标。结果匹配后每组143例配对成功,匹配后两组间基线特征无统计学差异。对比两组围手术期指标发现,猪尾巴管组患者术后3天胸腔引流总量显著多于胸管组(375.49 ml对285.03 ml,P<0.001),术后两周复查CT示胸腔积液量显著少于胸管组(131.77 ml对178.84 ml,P=0.032),两组术后疼痛评分、引流天数及住院天数无明显统计学差异。结论加放猪尾巴导管可有效改善单孔胸腔镜肺肿瘤术后胸腔引流情况,且不增加患者术后疼痛,不延长胸腔引流及住院天数。     

Uncertainty evaluation at three spatial scales for the NDVI-based VWC estimation method used in the SMAP algorithm

Vegetation water content (VWC) is the key input parameter for a soil moisture retrieval algorithm based on microwave remote sensing, and VWC uncertainty can limit the estimated accuracy of soil moisture. There has been little research on VWC algorithm development and validation in China, and the uncertainty of the VWC estimation method has not been well evaluated. Therefore, the aim of this study is to evaluate the uncertainty of the VWC estimation method used in the SMAP (Soil Moisture Active Passive) algorithm on three spatial scales (the point-scale, 30 m scale, and 1 km scale) for maize in northeast China. Results from three ground experimental datasets showed that the SMAP VWC estimation method was strongly biased with an average overestimation of 1.16 kg m^?2,1.04 kg m^?2, and 1.13 kg m^?2 for the point-scale, 30 m scale, and 1 km scale respectively, and maximum bias occurred in the mid-stage of maize. Also, a new power relationship between NDVI (Normalized Difference Vegetation Index) and VWC was proposed for the 30 m scale based on Sentinel 2 NDVI and field VWC values from 2017 experiment, with respective R² (coefficient of determination) and Root Mean Squared Error (RMSE) values of 0.80 and 0.67 kg m^?2. The results confirmed that this power relationship was still suitable for VWC estimation at the 1 km scale, and it has smaller bias than the original SMAP VWC method. Future work will be carried out to evaluate the applicability of this VWC estimation method over a lager region. It is expected that it can improve the accuracy of soil moisture by providing high precision VWC input parameters.