Background: The Omicron variant of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is highly transmissible but causes less severe disease compared to other variants. However, its association with sepsis incidence and outcomes is unclear. This study aimed to investigate the incidence of Omicron-associated sepsis, as per the Sepsis 3.0 definition, in hospitalized patients, and to explore its relationship with clinical characteristics and prognosis. Methods: This multicenter retrospective study included adults hospitalized with confirmed SARS-CoV-2 infection across six tertiary hospitals in Guangzhou, China from November 2022 to January 2023. The Sequential Organ Failure Assessment (SOFA) score and its components were calculated at hospital admission to identify sepsis. Outcomes assessed were need for intensive care unit (ICU) transfer and mortality. Receiver operating characteristic curves evaluated the predictive value of sepsis versus other biomarkers for outcomes. Results: A total of 299 patients (mean age: 70.1±14.4 years, 42.14% female) with SOFA score were enrolled. Among them, 152 were categorized as non-serious cases while the others were assigned as the serious group. The proportion of male patients, unvaccinated patients, patients with comorbidity such as diabetes, chronic cardiovascular disease, and chronic lung disease was significantly higher in the serious than non-serious group. The median SOFA score of all enrolled patients was 1 (interquartile range, 0–18). In our study, 147 patients (64.19%) were identified as having sepsis upon hospital admission, with the majority of these septic patients (113, representing 76.87%) being in the serious group, the respiratory, coagulation, cardiovascular, central nervous, and renal organ SOFA scores were all significantly higher in the serious compared to the non-serious group. Among septic patients, 20 out of 49 (40.81%) had septic shock as indicated by lactate measurement within 24 hours of admission, and the majority of septic patients were in the serious group (17/20, 76.87%). Sepsis was present in 118 out of 269 (43.9%) patients in the general ward, and among those with sepsis, 34 out of 118 (28.8%) later required ICU care during hospitalization. By contrast, none of the patients without sepsis required ICU care. Moreover, the mortality rate was significantly higher in patients with than without sepsis. Conclusions: A considerable proportion of patients infected with Omicron present with sepsis upon hospital admission, which is associated with a poorer prognosis. Therefore, early recognition of viral sepsis by evaluation of the SOFA score in hospitalized coronavirus disease 2019 patients is crucial.
Objective
To understand the situation of iodine deficiency disorders and iodine nutrition of children in Yunnan Province after the implementation of new standard of salt iodine, and provide the basic data for prevention and control of iodine deficiency disorders.
Methods
Using multistage sampling method, Yunnan provincial evaluations for iodine deficiency disorders elimination were carried out. According to the comparative analysis of 2010 (pre-adjustment) and 2015 (post-adjustment) evaluation results, the changes of the median of salt iodine, the coverage rate of iodized salt, the qualified rate of iodized salt, the rate of qualified iodized salt consumption, goiter rate of school children aged 8- 10 and the median of urinary iodine were evaluated. iodine was tested using the Salt Industry General Test Method for Determination of (GB/T 13025.7-1999); thyroid volume examination of children using B-scan ultrasonography, thyroid volume calculation and enlargement judgment using Diagnostic Criteria for Endemic Goiter (WS 276-2007); and urinary iodine detection using Urinary Iodine Arsenic Cerium Catalytic Spectrophotometry (WS/T 107-2006).
Results
The medians of salt iodine in 2010 and 2015 were 30.6 and 22.4 mg/kg, respectively, the difference was statistically significant (U= 317 503.50, P < 0.01). The coverage rates of iodized salt in 2010 and 2015 were 99.6% (1 681/1 688) and 98.9% (2 592/2 622), the qualified rates ofiodized salt were 98.6% (1 657/1 681) and 89.7% (2 325/2 592), and the rates of qualified iodized salt consumption were 98.2% (1 657/1 688) and 88.7% (2 325/2 622), and the differences were statistically significant (χ2= 6.42, 125.11, 130.18, P < 0.01); the rates of children goiter in 2010 and 2015 were 0.8% (25/3 272) and 1.4% (44/3 245), respectively; the medians of urinary iodine of children were 289.0 and 157.3 μg/L, respectively, the difference was statistically significant (U= 1 121 669.50, P < 0.01).
Conclusion
After decreasing of salt iodine level starting from 2012 in Yunnan Province, the children iodine nutrition condition is in a more proper level.
Key words:
Iodine; Salts; Urine; Nutrition assessment
ABSTRACT Tick‐borne encephalitis virus (TBEV) can cause life‐threatening central nervous system infection. Changes in cerebrospinal fluid (CSF) metabolites may reflect critical aspects of host responses and end‐organ damage in neuro infection and neuroinflammation. In this study, we applied an untargeted metabolomics screen of CSF samples to investigate the metabolites profile and explore biomarkers for TBEV infection. By analyzing CSF samples from 77 patients with TBEV infection and 23 without TBEV infection, tryptophan metabolism and Citrate cycle were found to be the top important metabolic pathways in differentiating the control and case groups; acetoacetate, 5′‐deoxy‐5′‐(methylthio)‐adenosine, 3‐methyl‐2‐oxobutanoic acid, and so forth. were identified to be metabolic biomarkers (|FC|> 1, VIP > 1, FDR < 0.05) in CSF and clearly separated the TBEV infection from the noninfected samples. Moreover, four metabolites were identified to be associated with fatal outcome, including kynurenic acid, 5‐hydroxyindole‐3‐acetic acid, DL‐tryptophan, indole‐3‐acrylic acid, demonstrating the potential predictive biomarkers for severe TBEV infection. This study explored the metabolic profile of TBEV infection in CSF samples and identified candidate biomarkers for TBEV infection, which might be useful in target screening for differential diagnosis and therapeutic inter‐vention.
Objective To investigate and analyze the prevalence and implementation of control measures of iodine deficiency disorders(IDD),to provide basis for emergency and intensifying iodine supplement measures in high risk area of Yongshan and Jiangcheng counties.Methods Questionnaire was carried out by going to housewives' households,edible salt was also collected to detect iodine content.Intelligence quotient level,urinary iodine concentration and thyroid gland size(by B ultrasonic and palpation)were investigated in students aged from 8 to 10 years old in school.New cases with endemic cretinism were searched for diagnosis.Results The coverage rate of iodized salt was 85.6%,86.7% in Yongshan County and Jiangcheng County,respectively.Out of that,it was 65.2% at Lianfeng countryside in Yongshan County.The edible rate of qualified iodized salt was 77.2%,86.1%.Goiter rate was 7.6%,11.3% by B ultra method,and 0.5%,0.9% by palpation,respectivly in children group.IQ average value and the standard deviation were 84.89±18.53,92.73±15.29.Urine iodine median was all less than 200μg/L in children,pregnant women and women in lactation.Awareness rate of IDD was less than 50% in housewife group in those two counties.Three new sporadic cases with cretinism were found in Yongshan County.Conclusions Iodine nutrition condition in children and women have been improved since edible salt supplied with iodine in the province,and iodine deficiency have been remedied,except for some local districts where the iodized salt rate is very low.In order to prevent and control IDD,we should develop heath education on IDD,reinforce the surveillance of non-iodized salt.In those areas with cretinism case and iodized salt coverage less than 80%,we should carry out emergency supplement of iodine in the high risk groups so as to timely prevent iodine deficiency.
Generally, hysteroscopy is not appropriate for pregnant women without an indication.What if a patient undergoes hysteroscopy accidentally during the early gestational period?We here report a rare case of a woman who continued pregnancy after a diagnostic hysteroscopy was performed in early pregnancy and delivered a healthy baby.The patient had a history of infertility and oligomenorrhea, probably due to a previous induced abortion.A hysteroscopy was performed after the end of her "menstruation" for assessment of her uterine cavity.Early pregnancy, instead of the expected intrauterine adhesions, was suspected, and the procedure was immediately ceased.Subsequent tests confirmed the diagnosis of pregnancy.She had a fullterm delivery by elective caesarean section.The success of this case was attributed to the use of vaginoscopic techniques in hysteroscopy and correct judgment and decision-making during the procedure.This case report provides some useful methods and experience that might be helpful when a similar situation occurs in clinical practice.
Objective
To analyze the iodine nutritional status in the key populations before and after the adjustment of iodized salt in Yunnan Province, and to provide scientific basis for adjusting the strategy of prevention and treatment timely.
Methods
The probability proportional to size sampling method was employed in the investigation. In the pre-adjustment period (2011) and the post-adjustment period (2014), the changes in the residents' iodized salt, the urinary iodine and goiter prevalence of children aged 8-10, the urinary iodine of pregnant women and lactating women were analyzed.
Results
Before and after adjusting the salt iodine concentration, the coverage rate of iodized salt was 99.1% (1 196/1 207) and 99.2% (1 532/1 545), respectively, the mean of salt iodine after the adjustment (23.6 mg/kg) was significantly lower than that of before(30.1 mg/kg, F= 17.287, P 0.05) .
Conclusions
After adjusting the salt iodine concentration in Yunnan Province, iodine nutrition of children has decreased from more than adequate level to adequate level, thyroid goiter rate of children has remained at the low level, and iodine nutrition of pregnant women is sightly lower than adequate level, but iodine deficiency of pregnant women is at a low risk because of the good iodized salt coverage. The new standard of iodized salt is appropriate, and it is more favorable to health in Yunnan Province.
Key words:
Salts; Iodine; Adjustment; Population; Nutrition
Coronaviruses (CoVs) are naturally found in bats and can occasionally cause infection and transmission in humans and other mammals. Our study aimed to build a deep learning (DL) method to predict the adaptation of bat CoVs to other mammals.The CoV genome was represented with a method of dinucleotide composition representation (DCR) for the two main viral genes, ORF1ab and Spike. DCR features were first analyzed for their distribution among adaptive hosts and then trained with a DL classifier of convolutional neural networks (CNN) to predict the adaptation of bat CoVs.The results demonstrated inter-host separation and intra-host clustering of DCR-represented CoVs for six host types: Artiodactyla, Carnivora, Chiroptera, Primates, Rodentia/Lagomorpha, and Suiformes. The DCR-based CNN with five host labels (without Chiroptera) predicted a dominant adaptation of bat CoVs to Artiodactyla hosts, then to Carnivora and Rodentia/Lagomorpha mammals, and later to primates. Moreover, a linear asymptotic adaptation of all CoVs (except Suiformes) from Artiodactyla to Carnivora and Rodentia/Lagomorpha and then to Primates indicates an asymptotic bats-other mammals-human adaptation.Genomic dinucleotides represented as DCR indicate a host-specific separation, and clustering predicts a linear asymptotic adaptation shift of bat CoVs from other mammals to humans via deep learning.
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