Case report: Oxaliplatin-induced idiopathic non-cirrhotic portal hypertension: a case report and literature review

Oxaliplatin has become a widely used agent in neoadjuvant chemotherapy for gastrointestinal tract tumors and is an integral part of the therapeutic approach for managing colorectal cancer recurrences and metastases, resulting in a more favorable prognosis for patients. Nevertheless, oxaliplatin can give rise to idiopathic non-cirrhotic portal hypertension (INCPH). The emergence of INCPH can disrupt tumor chemotherapy and incite persistent adverse reactions in later stages, significantly complicating clinical management. Consequently, we have presented a case report of INCPH induced by oxaliplatin chemotherapy with the aim of advancing the diagnosis and treatment of this condition, with a particular focus on the clinical manifestations. This study has ascertained that the condition is primarily attributed to complications related to portal hypertension, such as gastrointestinal bleeding, splenomegaly, and hypersplenism. The pathological features primarily involve hepatic sinus dilation and congestion, portal obstruction, absence, stenosis, shunting, localized venous and perisinusoidal fibrosis, as well as hepatocellular atrophy. Treatment primarily concentrates on strategies typically employed for cirrhosis. Endoscopic ligation, sclerotherapy, and non-selective beta-blockers (NSBBs) can be selected to prevent and treat variceal hemorrhage. Transjugular intrahepatic portosystemic shunt (TIPS) and liver transplantation can also be chosen for severe cases. Notably, despite the timely discontinuation of oxaliplatin, most patients continue to experience disease progression, ultimately resulting in a poor prognosis due to either tumor advancement or the ongoing progression of portal hypertension. This emphasizes the importance for physicians to be aware of and consider the risk of INCPH when prescribing oxaliplatin

Functional and postoperative outcomes after high-intensity interval training in lung cancer patients: A systematic review and meta-analysis

ObjectiveThe study evaluated the effects of high-intensity interval training (HIIT) on postoperative complications and lung function in patients with lung cancer compared to usual care.MethodsWe searched electronic databases in April 2022, including PubMed, Embase, the Cochrane Library, Web of Science, and the China National Knowledge Infrastructure (CNKI). Two authors independently applied the Cochrane Risk of Bias tool to assess the quality of RCTs. The postoperative complications, length of hospitalization, and cardiopulmonary functions from the studies were pooled for statistical analysis.ResultsA total of 12 randomized controlled trials were eligible for inclusion and were conducted in the meta-analysis. HIIT significantly increased VO2peak (MD = 2.65; 95% CI = 1.70 to 3.60; I2 = 40%; P <0.001) and FEV1 (MD = 0.12; 95% CI = 0.04 to 0.20; I2 = 51%; P = 0.003) compared with usual care. A subgroup analysis of studies that applied HIIT perioperatively showed significant improvement of HIIT on FEV1 (MD = 0.14; 95% CI = 0.08 to 0.20; I2 = 36%; P <0.0001). HIIT significantly reduced the incidence of postoperative atelectasis in lung cancer patients compared with usual care (RD = −0.16; 95% CI = −0.24 to −0.08; I2 = 24%; P <0.0001). There was no statistically significant effect of HIIT on postoperative arrhythmias (RD = −0.05; 95% CI = −0.13 to 0.03; I2 = 40%; P = 0.22), length of hospitalization (MD = −1.64; 95% CI = −3.29 to 0.01; P = 0.05), and the six-minute walk test (MD = 19.77; 95% CI = −15.25 to 54.80; P = 0.27) compared to usual care.ConclusionHIIT may enhance VO2peak and FEV1 in lung cancer patients and reduce the incidence of postoperative atelectasis. However, HIIT may not reduce the incidence of postoperative arrhythmia, shorten the length of hospitalization, or improve the exercise performance of patients with lung cancer.Systematic review registrationPROSPERO, CRD4202233544

Establishment and evaluation of a novel practical tool for the diagnosis of pre-sarcopenia in young people with diabetes mellitus

OBJECTIVE: Sarcopenia has been recognized as a third category of complications in people with diabetes. However, few studies focus on the reduction of skeletal muscle mass in young people with diabetes. The aim of this study was to investigate risk factors of pre-sarcopenia in young patients with diabetes and establish a practical tool to diagnose pre-sarcopenia in those people. METHODS: Patients (n = 1246) enrolled from the National Health and Nutrition Examination Survey (NHANES) cycle year of 2011 to 2018 were randomly divided into the training set and validation set. The all-subsets regression analysis was used to select the risk factors of pre-sarcopenia. A nomogram model for the prediction of pre-sarcopenia in the diabetic population was established based on the risk factors. The model was evaluated by the area under the receiver operating characteristic curve for discrimination, calibration curves for calibration, and decision curve analysis curves for clinical utility. RESULTS: In this study, gender, height, and waist circumference were elected as predictive factors for pre-sarcopenia. The nomogram model presented excellent discrimination in training and validation sets with areas under the curve of 0.907 and 0.912, respectively. The calibration curve illustrated excellent calibration, and the decision curve analysis showed a wide range of good clinical utility. CONCLUSION: This study develops a novel nomogram that integrates gender, height, and waist circumference and can be used to easily predict pre-sarcopenia in diabetics. The novel screen tool is accurate, specific, and low-cost, highlighting its potential value in clinical application

Erythromycin resistance of clinical Campylobacter jejuni and Campylobacter coli in Shanghai, China

Campylobacter species are zoonotic pathogens, as well as the prevalent cause of foodborne bacterial gastroenteritis. The spread of antimicrobial-resistant strains poses a serious threat to global public health and attracts attention worldwide, but information about clinical Campylobacter is relatively limited compared to isolates from food and animals. The current study illustrated the prevalence and antimicrobial resistance profiles of Campylobacter jejuni and Campylobacter coli isolates collected from a consecutive surveillance program between 2012 and 2019 in Shanghai, China, using antimicrobial susceptibility testing and whole-genome sequencing. Among the 891 Campylobacter strains (761 C. jejuni and 130 C. coli) isolates collected, high portions above 90% of resistance to ciprofloxacin, nalidixic acid, and tetracycline were observed for both C. jejuni and C. coli. The most common MDR profiles represented by C. jejuni and C. coli were combination of ciprofloxacin, tetracycline, florfenicol and nalidixic acid (5.39%), and azithromycin, ciprofloxacin, erythromycin, gentamicin, tetracycline, clindamycin, nalidixic acid (28.46%), respectively. The erythromycin resistance of C. coli (59.23%) is higher than C. jejuni (2.50%). A total of 76 erythromycin resistant isolates (16 C. jejuni and 60 C. coli) were sequenced using Illumina platform for determining the genotypes, antimicrobial resistance patterns and phylogeny analysis. Multilocus sequence typing (MLST) analysis showed a high genetic diversity with 47 sequence types (STs), including 4 novel alleles and 12 new STs. The most abundant clonal complexes (CCs) were CC-403 (31.25%) and CC-828 (88.33%) for C. jejuni and C. coli, respectively. Among the 76 erythromycin-resistant isolates, mutation A2075G in 23S rRNA and erm(B) gene were detected in 53.95 and 39.47%, respectively. The erm(B) gene was identified exclusively in 30 C. coli isolates. All these erm(B) positive isolates were multi-drug resistant. Furthermore, comparison of the erm(B)-carrying isolates of multiple sources worldwide demonstrated the possibility of zoonotic transmission of erm(B) in Campylobacter. These findings highlight the importance of continuous surveillance of erythromycin resistance dissemination in Campylobacter which may compromise the effectiveness of antimicrobial therapy

BMI mediates the association of serum uric acid with bone health: a cross-sectional study of the National Health and Nutrition Examination Survey (NHANES)

Abstract Background The associations between serum uric acid and osteoporosis or osteopenia remain controversial, and few studies have explored whether BMI acts as a mediators in the association between the SUA and OP/ osteopenia. Objective To explore the relationship between serum uric acid and osteoporosis or osteopenia among US adults. Methods A cross-sectional study was conducted to examine the association between serum uric acid and osteoporosis or osteopenia from four cycles of NHANES. Binary logistic regression models and restricted cubic spline models were used to evaluate the association between serum uric acid and osteoporosis or osteopenia, and interaction analysis was used to test the differences between subgroups. Mediation analysis was utilized to investigate whether BMI acts as a mediator in the association between SUA and OP/ osteopenia. Results 12581 participants aged ≥ 18 years were included. A U-shape nonlinear relationship between SUA and osteoporosis or osteopenia in all people was found (P < 0.0001, P for nonlinear = 0.0287). There were significant interactions in age subgroups (P for interaction = 0.044), sex subgroups (P for interaction = 0.005), and BMI subgroups (P for interaction = 0.017). We further assessed the subgroups and found the optimal range of serum uric acid levels with a lower risk of osteoporosis or osteopenia was 357–535 µmol/L in males, 327–417 µmol/L in people aged ≥ 50 years, above 309 µmol/L in people aged < 50 years, 344–445 µmol/L in people with BMI ≥ 30, and above 308 µmol/L in people with BMI < 30. BMI fully mediated the association of SUA and OP/osteopenia, with a value of -0.0024(-0.0026–-0.0021). These results were robust in sensitivity analyses. Conclusions A complicated relationship between SUA and bone health in different populations was observed. Maintaining SUA within a specific range may be beneficial to bone health. In addition, BMI may play an important role in the association between SUA and bone health, but considering the limitations of this study, further prospective research is required

Ni₂P/Graphene Sheets as Anode Materials with Enhanced Electrochemical Properties versus Lithium

Hybridizing Ni₂P/graphene sheet composite is successfully accomplished via a one-pot solvothermal method. As anode materials for lithium-ion batteries, the Ni₂P spheres with sizes of 10–30 nm can effectively prevent the agglomeration of graphene sheets. In turn, the graphene sheets with good electrical conductivity serve as a conducting network for fast electron transfer between the active materials and charge collector, as well as buffered spaces to accommodate the volume expansion/contraction during cycling. The cyclic stability and rate capability of Ni₂P are significantly improved after the incorporation of graphene sheets. After 50 cycles, the Ni₂P/graphene sheet hybrid delivers a capacity of 450 mA h g^–1 and 360 mA h g^–1 at a current density of 54.2 and 542 mA g^–1, respectively. The voltage hysteresis of Ni₂P with and without graphene sheets is also discussed. The incorporation of graphene sheets can partly decrease the voltage polarization, and modify the thickness of solid electrolyte interface (SEI) film

High-Conductivity Li₂ZrCl₆ Electrolytes via an Optimized Two-Step Ball-Milling Method for All-Solid-State Lithium–Metal Batteries

The combined advantages of good mechanical deformability, high Li+ conductivity, and strong compatibility with 4 V-class cathodes make halide solid-state electrolytes promising candidates for high-energy all-solid-state lithium–metal batteries (ASSLMBs). Among these, the cost-effective Li2ZrCl6 has garnered significant attention due to the non-inclusion of rare-earth metals. However, the conventional one-step ball-milling synthesized Li2ZrCl6 always exhibits an ionic conductivity lower than 5 × 10–4 S cm–1 in most literature. Here, a simple optimized two-step ball-milling strategy is adopted to achieve a high Li+ conductivity of nearly 1 × 10–3 S cm–1 at 30 °C for Li2ZrCl6. Simultaneously, the effects of rotational speed and ball-to-powder mass ratio on the structure and ionic conductivity of Li2ZrCl6 are investigated. The Li+ migration pathways in electrolytes are also studied by bond valence site energy (BVSE) calculations. Moreover, the application potential of the modified Li2ZrCl6 electrolyte in ASSLMBs assembled with the LiCoO2 cathode and the lithium–indium alloy anode has been studied. The ASSLMBs exhibit an initial discharge capacity of 123.4 mA h g–1 at room temperature (0.1 C) and a capacity retention of 71% after 50 cycles. Therefore, this study introduces an effective strategy for synthesizing high-performance halide electrolytes, thus facilitating the practical implementation of halide-based ASSLMBs

The Jiwozhai patch reef: A palaeobiodiversity hotspot in middle Givetian (Devonian) of South China

© 2020 This study is a detailed palaeontological and palaeoecological analysis of a middle Givetian (Middle Devonian) high-diversity patch reef located in a platform interior setting in South China. The location is Jiwozhai, Guizhou Province, in the Dushan Formation. A total of 83 species (including 23 undetermined species) belonging to 44 genera of reef organisms were identified, based on a detailed statistical analysis from 28 quadrats on the vertical section of the patch reef. The main reef builders are laminar and encrusting-behaviour stromatoporoids, laminar tabulate corals, and laminar encrusting chaetetids, forming coverstones to build the reef framework, while abundant massive and branching tabulate corals and solitary rugose corals are also important for the formation of the reef by filling the spaces between the components of the coverstones. Reef dwellers including brachiopods, bryozoans, tubeworms, calcified cyanobacteria and gastropods, are only scarcely distributed in the Jiwozhai patch reef, having little impact on the distribution pattern. Consistent with the densely distributed species at Jiwozhai, complex ecological relationships, including extensive encrustations, spatial competition, and symbiosis have also been found among different organisms. The high biodiversity level of the Jiwozhai patch reef in platform interior emphasizes that understanding of species richness and diversity of functional groups in different habitats is critical for Givetian reef ecosystem reconstruction. Location of the patch reef in a platform interior may be the reason for the high diversity biota. The results from the Jiwozhai patch reef are evidence for a stable reef structure with evenly distributed major reef-frame builders and complex ecological relationships. The high level of species diversity is a common feature in South China, as well localities of many other palaeocontinents during the Givetian Period.Strategic Priority Research Program (B) of Chinese Academy of Sciences (XDB26000000), National Natural Science Foundation of China (grant Nos. 41772004, 41802002) and Geological Survey projects of China geological survey (No. DD20201121, 12120113063200)

Chinese experts’ consensus on the Internet of Things-aided diagnosis and treatment of coronavirus disease 2019 (COVID-19)

The aim is to diagnose COVID-19 earlier and to improve its treatment by applying medical technology, the “COVID-19 Intelligent Diagnosis and Treatment Assistant Program (nCapp)” based on the Internet of Things. Terminal eight functions can be implemented in real-time online communication with the “cloud” through the page selection key. According to existing data, questionnaires, and check results, the diagnosis is automatically generated as confirmed, suspected, or suspicious of 2019 novel coronavirus (2019-nCoV) infection. It classifies patients into mild, moderate, severe or critical pneumonia. nCapp can also establish an online COVID-19 real-time update database, and it updates the model of diagnosis in real time based on the latest real-world case data to improve diagnostic accuracy. Additionally, nCapp can guide treatment. Front-line physicians, experts, and managers are linked to perform consultation and prevention. nCapp also contributes to the long-term follow-up of patients with COVID-19. The ultimate goal is to enable different levels of COVID-19 diagnosis and treatment among different doctors from different hospitals to upgrade to the national and international through the intelligent assistance of the nCapp system. In this way, we can block disease transmission, avoid physician infection, and epidemic prevention and control as soon as possible