Objective:To explore the association between Toll-like receptor (TLR) gene polymorphism and susceptibility to non-human immunodeficiency virus (HIV)-related cryptococcal meningitis in patients from Fujian Province.Methods:A total of 101 non-HIV patients with cryptococcal meningitis and 270 healthy controls in Huashan Hospital, Fudan University and Cangshan Hospital District, The 900th Hospital of the Joint Logistics Support Force from Fujian Province were prospectively enrolled in this case-control study. Genomic DNA was extracted. Genotyping was performed by multiplex SNaPshot technology on eight TLR single nucleotide polymorphism (SNP) which were reported to be related to cryptococcal meningitis but still lacking validations. The differences of gene polymorphism distributions were compared between all patients and healthy controls, and between patients without predisposing factors and healthy controls. Data were analyzed by chi-square test or Fisher exact test.Results:Except for TLR1 rs5743563, the distributions of allele frequency in seven tested TLR SNPs (TLR1 rs5743604, TLR2 rs3804099, TLR4 rs1927907, TLR6 rs3796508, TLR6 rs5743794, TLR9 rs164637 and TLR9 rs352140) were in Hardy-Weinberg equilibrium. Comparisons between cases and controls found that TLR2 rs3804099 T/T genotype (52.5%(53/101) vs 40.4%(109/270), odds ratio ( OR)=1.63, χ2=4.378, P=0.036) and TLR6 rs5743794 G/G genotype (44.6%(45/101) vs 32.2%(87/270), OR=1.69, χ2=4.877, P=0.027) were correlated with high risks of cryptococcal meningitis, while TLR6 rs3796508 G/G genotype ((83.2%(84/101) vs 92.6%(250/270), OR=0.40, χ2=7.271, P=0.007) and TLR9 rs164637 C/C genotype (96.0%(97/101) vs 100.0%(270/270), Fisher exact test , P=0.005) were found to be protective factors. Seventy out of 101 patients had no predisposing factors. Comparison between patients without predisposing factors and healthy controls also found similar results. TLR6 rs5743794 G/G genotype (52.9%(37/70) vs 32.2%(87/270), OR=2.36, χ2=10.216, P=0.001) was risk factor, while TLR6 rs3796508 G/G genotype (81.4%(57/70) vs 92.6%(250/270), OR=0.35, χ2=7.906, P=0.005) and TLR9 rs164637 C/C genotype (97.1%(68/70) vs 100.0%(270/270), Fisher exact test, P=0.042) were protective factors. Conclusion:TLR gene polymorphism is significantly associated with non-HIV-related cryptococcal meningitis, which indicates that TLR might play an important role in the pathogenesis of cryptococcal meningitis.

At present, there still exist some limitations in the laparoscopic surgery robot represented by da Vinci surgical robot, such as the lack of force feedback function. Doctor can not feel the force feedback while operating. In this paper, a new minimally invasive laparoscopic surgery robot system is designed. Based on the master side surgeon's console, stereo vision subsystem and the slave side surgical cart, the multi-dimensional instrument force feedback technology and force feedback based safety protection strategy are introduced. The design realizes the force sensing function of full state operation. Besides, a number of different live pig experiments are carried out. The amount of bleeding in these experiments is relatively small compared with the data of the same kind of surgical robots, which effectively validates the force feedback and surgical safety protection strategies of the new robot system.
Animals ; Equipment Design ; Laparoscopy ; instrumentation ; Minimally Invasive Surgical Procedures ; Robotic Surgical Procedures ; instrumentation ; Robotics ; Swine

OBJECTIVE: To explore the clinical characteristics and outcomes of adult critically ill patients with COVID-19 and identify the risk factors correlated with in-hospital deaths. METHODS: This study was conducted among 20 confirmed adult cases of COVID-19 in the Intensive Care Unit (ICU) of Honghu People's Hospital in Jingzhou City, Hubei Province. According to the final outcome, the patients were divided into survivor group and death group with 10 patients each. The demographic data, clinical manifestations and signs, laboratory findings, treatment measures and clinical outcomes were obtained from electronic medical records to compare the clinical characteristics and outcomes between the two groups. Univariate logistic analysis was used to analyze the risk factors associated with in-hospital death. RESULTS: The mean age of patients with confirmed COVID-19 was 70 ± 12 years, and 40% of them were male. The patients were admitted to ICU 11 ± 9 days after symptom onset. The most common symptoms on admission were cough (19 cases), fatigue or myalgia (18 cases), fever (17 cases) and dyspnea (16 cases). Eleven (55%) of the patients had underlying diseases, among which hypertension was the most common (11 cases), followed by cardiovascular disease (4 cases) and diabetes (3 cases). Six (30%) of the patients received invasive mechanical ventilation and continued renal replacement therapy but eventually died. Acute cardiac injury was the most common complication (19 cases). Half of the patients died between the 2nd and 19th day after ICU admission. Compared with dead patients, the surviving patients had a lower average body weight (61.70±2.36 68.60±7.15 kg, =0.01) and a higher Glasgow Coma Index (14.69 ± 0.70 12.70 ± 2.45, =0.03), and were less likely to develop shock (2 10, =0.001) or acute respiratory distress syndrome (2 10, =0.001). CONCLUSIONS Critically ill patients with COVID-19 are generally older. A higher body weight and a lower lymphocyte count are potentially associated with a greater likeliness of fatality in ICU patients with COVID-19.
Aged ; Aged, 80 and over ; Betacoronavirus ; Coronavirus Infections ; Critical Illness ; Female ; Humans ; Male ; Middle Aged ; Pandemics ; Pneumonia, Viral ; Retrospective Studies