Acute-on-chronic liver failure （ACLF） is a syndrome of multi-organ failure in patients with liver cirrhosis triggered by acute insult（s）， and it is characterized by a high risk of infection， systemic inflammation， multi-organ failure， and a high short-term mortality rate. However， there are differences in the definition of organ failure （OF） across major hepatology societies. In order to develop standardized OF criteria for patients with liver cirrhosis， an international panel of experts mainly from AASLD， EASL， and APASL developed new consensus statements on the diagnostic criteria for OF in liver cirrhosis， aiming to provide a basis for the diagnosis， prognostic evaluation， and clinical trials of ACLF. The consensus statements provide clear definitions for liver failure， infection and immune dysfunction， cerebral failure， renal failure， circulatory failure， respiratory failure， and gastrointestinal failure and systematically integrate the criteria for OF associated with liver cirrhosis for the first time， thereby establishing a core framework for research on ACLF mechanisms， standardization of clinical management， drug development， and assessment of priority for transplantation. Furthermore， the consensus statements identify the dynamic parameters that need to be validated in the future （such as the changes in bilirubin and lymphocyte-to-neutrophil ratio） and the novel biomarkers requiring further exploration. This article gives an excerpt of the core contents of the consensus statements.

Non-muscle myosin heavy chain 9-related disease (MYH9-RD) is an autosomal dominant disease caused by the mutations of the MYH9 gene encoding the non-muscle mysoin heavy chain ⅡA and leads to abnormal accumulation of myosin in cells. These further causes functional disorders of the blood, eye, ear, kidney, and liver systems. MYH9-RD displays heterogeneous kidney involvement and outcomes, but doctors still lack understandings of the mechanism and treatment strategies, owing to difficulty of conducting renal biopsies. Here, we report a case of MYH9-RD with tail fragments heterozygous mutation, which renal pathology is presented as glomerular minor lesion. Moreover, we reviewed related relevant to strengthen clinical diagnosis and understanding of MYH9-RD.

Using the liquid chromatography-tandem mass spectrometry (LC-MS/MS) to determine the plasma level of Lyso-GL3 in patients with Fabry disease and to analyze the clinical application of the method.

COVID-19 has been prevalent for three years. The virulence of SARS-CoV-2 is weaken as it mutates continuously. However, elderly patients, especially those with underlying diseases, are still at high risk of developing severe infections. With the continuous study of the molecular structure and pathogenic mechanism of SARS-CoV-2, antiviral drugs for COVID-19 have been successively marketed, and these anti-SARS-CoV-2 drugs can effectively reduce the severe rate and mortality of elderly patients. This article reviews the mechanism, clinical medication regimens, drug interactions and adverse reactions of five small molecule antiviral drugs currently approved for marketing in China, so as to provide advice for the clinical rational use of anti-SARS-CoV-2 in the elderly.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was reported at the end of 2019 as a worldwide health concern causing a pandemic of unusual viral pneumonia and many other organ damages, which was defined by the World Health Organization as coronavirus disease 2019 (COVID-19). The pandemic is considered a significant threat to global public health till now. In this review, we have summarized the lessons learnt during the emergence and spread of SARS-CoV-2, including its prototype and variants. The overall clinical features of variants of concern (VOC), heterogeneity in the clinical manifestations, radiology and pathology of COVID-19 patients are also discussed, along with advances in therapeutic agents.
Humans ; COVID-19 ; SARS-CoV-2 ; Pneumonia, Viral/prevention & control* ; Global Health ; China/epidemiology*

Due to the difficult eradication of Helicobacter pylori caused by gradual increase of antibiotic resistance, the widespread use of nonsteroidal anti‑inflammatory drugs, and the common use of antithrombotic therapy in the aging population, the diagnosis and treatment of peptic ulcer are more challenging than ever. To further explore a new model of diagnosis and treatment of peptic ulcer in accordance with our national conditions, the Editorial Board of Chinese Journal of Digestion organized an expert committee to develop a new version of the consensus based on "Standardized diagnosis and treatment of peptic ulcer (2016, Xi′an)". The consensus has 30 statements, divided into 9 parts, covering the definition, clinical manifestations, pharmacological treatment, treatment of complications, and prevention of peptic ulcer.

Humans ; Asthma/drug therapy* ; Biological Therapy

The optimal protocol for neuromodulation by transcranial direct current stimulation (tDCS) remains unclear. Using the rotarod paradigm, we found that mouse motor learning was enhanced by anodal tDCS (3.2 mA/cm²) during but not before or after the performance of a task. Dual-task experiments showed that motor learning enhancement was specific to the task accompanied by anodal tDCS. Studies using a mouse model of stroke induced by middle cerebral artery occlusion showed that concurrent anodal tDCS restored motor learning capability in a task-specific manner. Transcranial in vivo Ca²⁺ imaging further showed that anodal tDCS elevated and cathodal tDCS suppressed neuronal activity in the primary motor cortex (M1). Anodal tDCS specifically promoted the activity of task-related M1 neurons during task performance, suggesting that elevated Hebbian synaptic potentiation in task-activated circuits accounts for the motor learning enhancement. Thus, application of tDCS concurrent with the targeted behavioral dysfunction could be an effective approach to treating brain disorders.
Transcranial Direct Current Stimulation/methods* ; Motor Cortex/physiology* ; Neurons ; Transcranial Magnetic Stimulation

The Ly-6 and uPAR (LU) domain-containing proteins represent a large family of cell-surface markers. In particular, mouse Ly-6A/Sca-1 is a widely used marker for various stem cells; however, its human ortholog is missing. In this study, based on a systematic survey and comparative genomic study of mouse and human LU domain-containing proteins, we identified a previously unannotated human gene encoding the candidate ortholog of mouse Ly-6A/Sca-1. This gene, hereby named LY6A, reversely overlaps with a lncRNA gene in the majority of exonic sequences. We found that LY6A is aberrantly expressed in pituitary tumors, but not in normal pituitary tissues, and may contribute to tumorigenesis. Similar to mouse Ly-6A/Sca-1, human LY6A is also upregulated by interferon, suggesting a conserved transcriptional regulatory mechanism between humans and mice. We cloned the full-length LY6A cDNA, whose encoded protein sequence, domain architecture, and exon-intron structures are all well conserved with mouse Ly-6A/Sca-1. Ectopic expression of the LY6A protein in cells demonstrates that it acts the same as mouse Ly-6A/Sca-1 in their processing and glycosylphosphatidylinositol anchoring to the cell membrane. Collectively, these studies unveil a novel human gene encoding a candidate biomarker and provide an interesting model gene for studying gene regulatory and evolutionary mechanisms.
Humans ; Membrane Proteins/genetics* ; Pituitary Neoplasms/genetics* ; Biomarkers

Objective To establish a predictive model using multiple layer perceptron (MLP) for short-term outcome after subacute ischemic stroke.Methods From January, 2019 to September, 2021, 60 readmission-inpatients in Department of Rehabilitation, Ruijin Hospital, Shanghai Jiaotong University School of Medicine were collected the clinical features of first admission (less than 30 days after attack), and the outcomes were assessed with modified Rankin Scale (MRS) three months after the first admission. The risk factors were screened with single factor analysis, and the short-term outcome predictive models were established with multi-factor Logistic regression and MLP. The predictive accuracy of both models was calculated, and the predictive effects were compared with Receiver Operating Characteristic (ROC) curve.Results For multi-factor Logistic regression, the predictive accuracy was 73.3%, and the area under ROC curve was 0.851. For MLP, the predictive accuracy was 88.9%, and the area under the ROC curve was 0.930.Conclusion The prediction of short-term outcome after subacute ischemic stroke can be done with MLP model.