Rapid and accurate detection of Streptococcus pneumoniae (Sp), Haemophilus influenzae type b (Hib) and Mycobacterium tuberculosis complex (MTBC) in sputum by conventional methods remains problematic. Primers based on capsular polysaccharide biosynthesis gene (cpsA), the region II of the capsulation locus (cap), the insertion sequence IS6110 were designed for Sp, Hib, MTBC respectively. These primers were incorporated in a multiplex touchdown PCR assay for simultaneous detection of Sp, Hib and MTBC. The multiplex touchdown PCR assay was evaluated using standard strains and clinical sputum samples. The multiplex touchdown PCR assay showed 100% specificity in identifying Sp, Hib, MTBC from pure culture of standard strains. The sensitivities of the multiplex touchdown PCR assay were 94%, 98%, 98% for detection of Sp, Hib and MTBC respectively based on culture results while evaluated using 492 consecutive qualified clinical sputum samples; the specificities were all 100%. This highly sensitive and specific multiplex touchdown PCR assay offers a rapid and simple method for detection of Sp, Hib and MTBC in clinical sputum samples.

The stereo-structure of the orbit is affected by several orbital diseases, e.g. congenital orbital dysplasia, orbital fracture, and intraorbital tumor. The three-dimensional (3D) reconstruction technique serves as a practical tool in diagnosis, surgical planning, and outcome prediction of plastic and reconstructive surgery. In our study, the morphologic features of the Mongolianadult orbit were described by 11 anatomic parameters using a 3D reconstruction technique and quantitative morphometry. The morphologic parameters of orbit such as bony orbital volume, orbital foramen area and orbital rim perimeter were measured on 3D models using this technique. Three-dimensional (3D) reconstruction based on high-resolution spiral computed tomography (CT) scans has been used for more than 10 years to reveal the anatomic location and morphologic features of orbital abnormalities and plays a important role in diagnosis, surgicalplanning, and outcome prediction. The findings of the study would allow for quantification of the orbital features of Mongolian adults and provide parameters for preoperative planning and prediction of postoperative outcome.

The shortage of medical resources promotes medical treatment reform, and smart healthcare is a promising strategy to solve this problem. With the development of Internet, real-time health status is expected to be monitored at home by using flexible healthcare systems, which puts forward new demands on flexible substrates for sensors. Currently, the flexible substrates are mainly traditional petroleum-based polymers, which are not renewable. As a natural polymer, cellulose, owing to its wide range of sources, convenient processing, biodegradability and so on, is an ideal alternative. In this review, the application progress of nanocellulose in flexible sensors is summarized. The structure and the modification methods of cellulose and nanocellulose are introduced at first, and then the application of nanocellulose flexible sensors in real-time medical monitoring is summarized. Finally, the advantages and future challenges of nanocellulose in the field of flexible sensors are discussed.
Cellulose/chemistry* ; Hydrogels/chemistry* ; Polymers

It is a significant challenge to improve the blood-brain barrier (BBB) permeability of central nervous system (CNS) drugs in their development. Compared with traditional pharmacokinetic property tests, machine learning techniques have been proven to effectively and cost-effectively predict the BBB permeability of CNS drugs. In this study, we introduce a high-performance BBB permeability prediction model named balanced-stacking-learning based BBB permeability predictor(BSL-B3PP). Firstly, we screen out the feature set that has a strong influence on BBB permeability from the perspective of medicinal chemistry background and machine learning respectively, and summarize the BBB positive(BBB+) quantification intervals. Then, a combination of resampling algorithms and stacking learning(SL) algorithm is used for predicting the BBB permeability of CNS drugs. The BSL-B3PP model is constructed based on a large-scale BBB database (B3DB). Experimental validation shows an area under curve (AUC) of 97.8% and a Matthews correlation coefficient (MCC) of 85.5%. This model demonstrates promising BBB permeability prediction capability, particularly for drugs that cannot penetrate the BBB, which helps reduce CNS drug development costs and accelerate the CNS drug development process.
Blood-Brain Barrier ; Algorithms ; Area Under Curve ; Databases, Factual ; Permeability

The incidence of complications after radical resection of esophageal carcinoma is high up to about 20%-50%. The incidence of pneumonia, pleural effusion, tracheal intubation, anastomotic fistula and cardiac events is relatively high. Among them, pulmonary complications are the most common complications after esophageal cancer operation and cause the most perioperative deaths. Among the factors that influence the occurrence of postoperative complications of esophageal cancer, the amount of fluid infusion during and after the operation is closely related to the occurrence of postoperative complications. Moreover, in the environment of enhanced recovery after surgery (ERAS), it is more important to optimize the postoperative fluid management of esophageal cancer. Restricted fluid therapy plays a more and more important role in patients undergoing esophagectomy. This review integrated the relevant research results and discussed the advantages of the restricted fluid therapy compared with other fluid therapy, how to control the restricted infusion volume and infusion speed and how to monitor and evaluate the infusion process and the selection of infusion types, so as to provide reference for clinical practice test.

Objective    To investigate the clinical value of artificial intelligence (AI)-assisted chest computed tomography (CT) in the diagnosis of peripheral lung shadow. Methods    The CT image data of 810 patients with peripheral pulmonary shadow treated by thoracic surgery in Tianjin Chest Hospital Affiliated to Tianjin University from January 2018 to July 2019 were retrospectively analyzed using AI-assisted chest CT imaging diagnosis system. There were 339 males and 471 females with a median age of 63 years. The malignant probability of preoperative AI-assisted diagnosis of peripheral pulmonary shadow was compared with the results of postoperative pathology. Results    The pathological diagnosis of 810 patients with peripheral pulmonary shadow was lung cancer in 627 (77.4%) patients, precancerous lesion in 30 (3.7%) patients and benign lesion in 153 (18.9%) patients. The median probability of malignant AI diagnosis before operation was 86.0% (lung cancer), 90.0% (precancerous lesion) and 37.0% (benign lesion), respectively. According to the analysis of receiver operating characteristic (ROC) curve of AI malignant probability distribution in this group of patients, the area under the ROC curve was 0.882. The critical value of malignant probability for diagnosis of lung cancer was 75.0%with a sensitivity of 0.856 and specificity of 0.814. A total of 571 patients were diagnosed with AI malignancy probability≥ 75.0%, among whom 537 patients were pathologically diagnosed as lung cancer with a positive predictive value of 94.0%(537/571). Conclusion    The AI-assisted chest CT diagnosis system has a high accuracy in the diagnosis of peripheral lung cancer with malignant probability≥75.0% as the diagnostic threshold.

This study aims to clarify host factors of IFN treatment in the treatment of chronic hepatitis B (CHB) patients by screening the differentially expressed genes of IFN pathway CHB patients with different response to interferon (IFN) therapy. Three cases were randomly selected in IFN-responding CHB patients (Rs), non-responding CHB patients (NRs) and healthy participants, respectively. The human type I IFN response RT ² profiler PCR array was used to detect the expression levels of IFN-related genes in peripheral blood monocytes (PBMCs) from healthy participants and CHB patients before and after Peg-IFN-α 2a treatment. The results showed that more differentially expressed genes appeared in Rs group than NRs group after IFN treatment. Comparing with healthy participants, IFNG, IL7R, IRF1, and IRF8 were downregulated in both Rs and NRs group before IFN treatment; CXCL10, IFIT1, and IFITM1 were upregulated in the Rs; IL13RA1 and IFI35 were upregulated in the NRs, while IFRD2, IL11RA, IL4R, IRF3, IRF4, PYHIN1, and ADAR were downregulated. The expression of IL15, IFI35 and IFI44 was downregulated by 4.09 ( t = 10.58, P < 0.001), 5.59 ( t = 3.37, P = 0.028) and 10.83 ( t = 2.8, P = 0.049) fold in the Rs group compared with the NRs group, respectively. In conclusion, IFN-response-related gene array is able to evaluate IFN treatment response by detecting IFN-related genes levels in PBMC. High expression of CXCL10, IFIT1 and IFITM1 before treatment may suggest satisfied IFN efficacy, while high expression of IL13RA1, IL15, IFI35 and IFI44 molecules and low expression of IFRD2, IL11RA, IL4R, IRF3, IRF4, PYHIN1 and ADAR molecules may be associated with poor IFN efficacy.
Humans ; Healthy Volunteers ; Hepatitis B, Chronic/genetics* ; Immunotherapy ; Interleukin-15 ; Leukocytes, Mononuclear ; Nuclear Proteins ; Oligonucleotide Array Sequence Analysis/methods* ; Interferons/therapeutic use* ; Treatment Outcome

Autophagy is a programmed cell degradation process that is involved in a variety of physiological and pathological processes including malignant tumors. Abnormal induction of autophagy plays a key role in the development of hepatocellular carcinoma (HCC). We established a prognosis prediction model for hepatocellular carcinoma based on autophagy related genes. Two hundred and four differentially expressed autophagy related genes and basic information and clinical characteristics of 377 registered hepatocellular carcinoma patients were retrieved from the cancer genome atlas database. Cox risk regression analysis was used to identify autophagy-related genes associated with survival, and a prognostic model was constructed based on this. A total of 64 differentially expressed autophagy related genes were identified in hepatocellular carcinoma patients. Five risk factors related to the prognosis of hepatocellular carcinoma patients were determined by univariate and multivariate Cox regression analysis, including TMEM74, BIRC5, SQSTM1, CAPN10 and HSPB8. Age, gender, tumor grade and stage, and risk score were included as variables in multivariate Cox regression analysis. The results showed that risk score was an independent prognostic risk factor for patients with hepatocellular carcinoma ( HR = 1.475, 95% CI = 1.280-1.699, P < 0.001). In addition, the area under the curve of the prognostic risk model was 0.739, indicating that the model had a high accuracy in predicting the prognosis of hepatocellular carcinoma. The results suggest that the new prognostic risk model for hepatocellular carcinoma, established by combining the molecular characteristics and clinical parameters of patients, can effectively predict the prognosis of patients.
Autophagy/genetics* ; Biomarkers, Tumor/genetics* ; Carcinoma, Hepatocellular/pathology* ; Humans ; Liver Neoplasms/pathology* ; Membrane Proteins/genetics* ; Prognosis

Smart wearable devices play an increasingly important role in physiological monitoring and disease prevention because they are portable, real-time, dynamic and continuous.The popularization of smart wearable devices among people under high-altitude environment would be beneficial for the prevention for heart and brain diseases related to high altitude. The current review comprehensively elucidates the effects of high-altitude environment on the heart and brain of different population and experimental subjects, the characteristics and applications of different types of wearable devices, and the limitations and challenges for their application. By emphasizing their application values, this review provides practical reference information for the prevention of high-altitude disease and the protection of life and health.
Altitude ; Brain Diseases ; Heart ; Humans ; Monitoring, Physiologic ; Wearable Electronic Devices

OBJECTIVE: To review the advancement made in the understanding of valgus impacted proximal humeral fracture (PHF). METHODS: The domestic and foreign literature about the valgus impacted PHF was extensively reviewed and the definition, classification, pathological features, and treatment of valgus impacted PHFs were summarized. RESULTS: PHF with a neck shaft angle ≥160° is recognized as a valgus impacted PHF characterized by the preservation of the medial epiphyseal region of the humeral head, which contributes to maintenance of the medial periosteum's integrity after fracture and reduces the occurrence of avascular necrosis. Therefore, the valgus impacted PHF has a better prognosis when compared to other complex PHFs. The Neer classification designates it as a three- or four-part fracture, while the AO/Association for the Study of Internal Fixation (AO/ASIF) categorizes it as type C (C1.1). In the management of the valgus impacted PHF, the selection between conservative and surgical approaches is contingent upon the patient's age and the extent of fracture displacement. While conservative treatment offers the advantage of being non-invasive, it is accompanied by limitations such as the inability to achieve anatomical reduction and the potential for multiple complications. Surgical treatment includes open reduction combined with steel wire or locking plate and/or non-absorbable suture, transosseous suture technology, and shoulder replacement. Surgeons must adopt personalized treatment strategies for each patient with a valgus impacted PHF. Minimally invasive surgery helps to preserve blood supply to the humeral head, mitigate the likelihood of avascular necrosis, and reduce postoperative complications of bone and soft tissue. For elderly patients with severe comminuted and displaced fractures, osteoporosis, and unsuitable internal fixation, shoulder joint replacement is the best treatment option. CONCLUSION Currently, there has been some advancement in the classification, vascular supply, and management of valgus impacted PHF. Nevertheless, further research is imperative to assess the clinical safety, biomechanical stability, and indication of minimally invasive technology.
Aged ; Humans ; Bone Plates ; Bone Wires ; Fracture Fixation, Internal/adverse effects* ; Fractures, Comminuted/surgery* ; Humeral Fractures ; Osteonecrosis ; Retrospective Studies ; Shoulder Fractures/surgery* ; Treatment Outcome