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The 2019 novel coronavirus (2019-nCoV) causing an outbreak of pneumonia in Wuhan, Hubei province of China was isolated in January 2020. This study aims to investigate its epidemiologic history, and analyze the clinical characteristics, treatment regimens, and prognosis of patients infected with 2019-nCoV during this outbreak. Clinical data from 137 2019-nCoV-infected patients admitted to the respiratory departments of nine tertiary hospitals in Hubei province from December 30, 2019 to January 24, 2020 were retrospectively collected, including general status, clinical manifestations, laboratory test results, imaging characteristics, and treatment regimens. None of the 137 patients (61 males, 76 females, aged 20-83 years, median age 57 years) had a definite history of exposure to Huanan Seafood Wholesale Market. Major initial symptoms included fever (112/137, 81.8%), coughing (66/137, 48.2%), and muscle pain or fatigue (44/137, 32.1%), with other, less typical initial symptoms observed at low frequency, including heart palpitations, diarrhea, and headache. Nearly 80% of the patients had normal or decreased white blood cell counts, and 72.3% (99/137) had lymphocytopenia. Lung involvement was present in all cases, with most chest computed tomography scans showing lesions in multiple lung lobes, some of which were dense; ground-glass opacity co-existed with consolidation shadows or cord-like shadows. Given the lack of effective drugs, treatment focused on symptomatic and respiratory support. Immunoglobulin G was delivered to some critically ill patients according to their conditions. Systemic corticosteroid treatment did not show significant benefits. Notably, early respiratory support facilitated disease recovery and improved prognosis. The risk of death was primarily associated with age, underlying chronic diseases, and median interval from the appearance of initial symptoms to dyspnea. The majority of patients with 2019-nCoV pneumonia present with fever as the first symptom, and most of them still showed typical manifestations of viral pneumonia on chest imaging. Middle-aged and elderly patients with underlying comorbidities are susceptible to respiratory failure and may have a poorer prognosis.

A middle‐aged man experienced intermittent acupuncture‐like pain in the skin of the right scrotum and medial thigh 1 month after undergoing laparoscopic high ligation of the right hernial sac for a right indirect inguinal hernia in November 2020, and the pain persisted for 6 months. Under ultrasound guidance, ilioinguinal and genitofemoral nerve block and local adhesion water separation were performed with a mixture of 0.25% lidocaine (6 mL) plus prednisolone acetate (10 mg), and the same drugs and methods were repeated five times once a week. After five treatments, the visual analogue scale (VAS) score was reduced from 7 before treatment to 1. During the follow‐up period, at 3 months after the end of treatment, the VAS score remained at 0, and this score was sustained at 0 even at the 6‐month follow‐up. These outcomes indicate that ultrasound‐guided nerve block combined with water separation technology can effectively alleviate neuralgia caused by surgical adhesion, which holds important clinical significance in managing such conditions. A middle‐aged man presented with a right indirect inguinal hernia in November 2020 and underwent laparoscopic high ligation of the right hernial sac. Intermittent acupuncture‐like pain in the skin of the right scrotum and medial thigh occurred 1 month after surgery and lasted for 6 months. Under ultrasound guidance, ilioinguinal nerve and genitofemoral nerve block and local adhesion water separation were performed with 0.25% lidocaine 6 mL plus prednisolone acetate 10 mg mixture, and the same drugs and methods were used for five treatments (once a week). After five treatments, the visual analogue scale (VAS) score was reduced from 7 before treatment to 1. The VAS score of the follow‐up patients was 0 at 3 months after the end of treatment, and the VAS score of the follow‐up patients was still 0 at half a year. It can be seen that ultrasound‐guided nerve block combined with water separation technology can be used for neuralgia caused by surgical adhesion, which has important clinical significance.

BackgroundHepatic steatosis that occasionally results in nonalcoholic steatohepatitis (NASH) is related to obstructive sleep apnea (OSA). Many studies have shown that autophagy exerts protective effects on liver damage caused by various diseases and melatonin exhibits hepatoprotective properties. However, the mechanisms of liver injury induced by chronic intermittent hypoxia (CIH) and the effect of melatonin on the regulation of liver injury remain unclear.PurposeThis study was aimed to evaluate the role of CIH in steatohepatitis progression and the regulatory function of melatonin on fatty liver sensitivity to CIH injury, mainly focusing on autophagy signaling.MethodsA high-fat diet (FD)-induced obesity mouse model was subjected to intermittent hypoxia/normoxia events for approximately 8 h per day using an autophagy agonist, rapamycin, or an inhibitor, 3-methyladenine (3-MA), and SRT1720, a sirtuin 1 (SIRT1) activator, or sirtinol, a SIRT1 inhibitor, with or without melatonin for a total of six successive weeks, followed by assessment of expression of autophagy-related genes and activity of serum aminotransferase as well as histological evaluation of tissue morphology.ResultsNeither FD nor CIH alone causes significant liver injury; however, the combination yielded higher serum aminotransferase activities and more severe histological changes, accompanied by a decrease in autophagy activity. Melatonin markedly inhibited FD/CIH-stimulated liver injury by enhancing autophagy. In contrast, SIRT1 inhibition resulted in a decrease in the expression of melatonin-induced autophagy-related genes as well as diminished its protective effects on FD/CIH-induced liver injury.ConclusionThese results suggest that melatonin could ameliorate FD/CIH-induced hepatocellular damage by activating SIRT1-mediated autophagy signaling.

Background S100β is a biomarker of astroglial damage, the level of which is significantly increased following brain injury. However, the characteristics of S100β and its association with prognosis in patients with acute ischemic stroke following intravenous thrombolysis (IVT) remain unclear. Methods Patients in this multicenter prospective cohort study were prospectively and consecutively recruited from 16 centers. Serum S100β levels were measured 24 h after IVT. National Institutes of Health Stroke Scale (NIHSS) and hemorrhagic transformation (HT) were measured simultaneously. NIHSS at 7 days after stroke, final infarct volume, and modified Rankin Scale (mRS) scores at 90 days were also collected. An mRS score ≥ 2 at 90 days was defined as an unfavorable outcome. Results A total of 1072 patients were included in the analysis. The highest S100β levels (> 0.20 ng/mL) correlated independently with HT and higher NIHSS at 24 h, higher NIHSS at 7 days, larger final infarct volume, and unfavorable outcome at 3 months. The patients were divided into two groups based on dominant and non-dominant stroke hemispheres. The highest S100β level was similarly associated with the infarct volume in patients with stroke in either hemisphere (dominant: β 36.853, 95% confidence interval (CI) 22.659–51.048, P  < 0.001; non-dominant: β 23.645, 95% CI 10.774–36.516, P  = 0.007). However, serum S100β levels at 24 h were more strongly associated with NIHSS scores at 24 h and 3-month unfavorable outcome in patients with dominant hemisphere stroke (NIHSS: β 3.470, 95% CI 2.392–4.548, P  < 0.001; 3-month outcome: odds ratio (OR) 5.436, 95% CI 2.936–10.064, P  < 0.001) than in those with non-dominant hemisphere stroke (NIHSS: β 0.326, 95% CI  − 0.735–1.387, P  = 0.547; 3-month outcome: OR 0.882, 95% CI 0.538–1.445, P  = 0.619). The association of S100β levels and HT was not significant in either stroke lateralization group. Conclusions Serum S100β levels 24 h after IVT were independently associated with HT, infarct volume, and prognosis in patients with IVT, which suggests the application value of serum S100β in judging the degree of disease and predicting prognosis.

Background: This study integrates transcriptomics and polysomnography (PSG) to investigate the core signaling pathways underlying obstructive sleep apnea (OSA), aiming to elucidate its complex pathophysiological mechanisms. These findings may provide new perspectives on the prevention, diagnosis, and treatment of OSA. Methods: Participants underwent PSG to monitor indicators, such as total sleep time, apnea–hypopnea index (AHI), oxygen desaturation index (ODI) and lowest oxygen saturation (LSO 2 ). Individuals with AHI > 5 were categorised into the OSA group, while others were classified as the regular snoring group. Total RNA from white blood cells was extracted using the TRIzol method, and transcriptomic data were obtained via high‐throughput sequencing. Weighted Gene Coexpression Network Analysis (WGCNA) and Protein–Protein Interaction (PPI) network analysis were used to identify OSA‐related core genes. Differential gene expression, Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses were conducted to explore key signaling pathways. Single‐cell sequencing validated the findings, and Mendelian randomization (MR) analysis confirmed causal links between genes and pathways. Results: While no significant differences were observed between the OSA and regular snoring groups in gender, age, or body mass index (BMI), significant disparities were noted in sleep parameters such as AHI, ODI, and LSO 2 . Principal component analysis (PCA) revealed transcriptomic differences between the groups. WGCNA identified 302 differentially expressed genes (DEGs), with the Palevioletred module significantly correlating with PSG parameters. GO and KEGG analyses implicated core genes in regulating inflammation, viral defence, cell growth, and apoptosis, highlighting the NF‐κB signaling pathway as central to OSA pathogenesis. PPI analysis identified key genes, including CEBPB and SPI1, while single‐cell sequencing suggested NF‐κB pathway activation affecting T cell subgroup distribution. MR confirmed causal relationships between core genes and the NF‐κB pathway. Conclusion: This study identified significant differences in sleep parameters between OSA and regular snoring groups and revealed core genes enriched in the NF‐κB signaling pathway. These findings suggest that targeting the NF‐κB pathway may offer therapeutic benefits for OSA.

Purpose Endoplasmic reticulum (ER) stress is known to play key roles in the development of endothelial cell apoptosis induced by chronic intermittent hypoxia (CIH), and the angiotensin II–phospholipase C–inositol-1,4,5-triphosphate (AngII-PLC-IP3) pathway has been demonstrated to induce ER stress. To explore whether the AngII-PLC-IP3 pathway is involved in the vascular damage induced by CIH, we examined whether the AngII-PLC-IP3 pathway is involved in ER stress induced by CIH and whether losartan, a selective angiotensin II type 1 receptor (AT1R) blocker, could suppress endothelial cell apoptosis induced by CIH. Methods Adult male Sprague Dawley rats were subjected to 8 h/day of intermittent hypoxia/normoxia, with or without losartan, a selective AT1R blocker, and/or U73122, a selective PLC inhibitor, for 8 weeks. Endothelial cell apoptosis, ER stress markers, and levels of PLC-γ1 and IP3R expression were determined. Results Losartan prevented increases in PLC-γ1 and IP3R protein levels and inhibited ER stress markers induced by CIH. Addition of U73122 reproduced all the protective effects of losartan. Losartan administration before CIH significantly ameliorated CIH-induced endothelial cell apoptosis. Conclusions This study showed that the AngII-PLC-IP3 pathway is involved in ER stress induced by CIH and that pre-losartan administration ameliorates endothelial cell apoptosis following CIH partly via inhibition of the AngII-PLC-IP3 pathway and ER stress.

Background： Chronic kidney disease （CKD） with moderate-to-severe renal dysfunction usually exhibits an irreversible course, and available treatments for delaying the progression to end-stage renal disease are limited. This study aimed to assess the efficacy and safety of the traditional Chinese medicine, Niaoduqing particles, for delaying renal dysfunction in patients with stage 3b-4 CKD.Methods： The present study was a prospective, randomized, double-blind, placebo-controlled, naulticentcr clinical trial. Frorn May 2013 to December 2013,300 CKD patients with an estimated glomerular filtration rate （eGFR） between 20 and 45 ml ＂rain ~＂ 1.73 m 2, aged 18-70 years were recruited from 22 hospitals in 11 Chinese provinces. Patients were randomized in a 1：1 ratio to either a test group, which was administered Niaoduqing particles 5 g thrice daily and 10 g before bedtime for 24 weeks, or a control group, which was administered a placebo using the same methods. The primary endpoints were changes in baseline serum creatinine （Scr） and eGFR after completion of treatment. The primary endpoints were analyzed using Student＇s t-test or Wilcoxon＇s rank-sum test. The present study reported results based on an intention-to-treat （ITT） analysis. Results： A total of 292 participants underwent the ITT analysis. At 24 weeks, the median （interquartile range） change in Scr was 1.1 （-13.0-24.1） and 11.7 （-2.6-42.9） p, mol/L for the test and control groups, respectively （Z = 2.642, P = 0.008）, and the median change in eGFR was -0.2 （-4.3-2.7） and -2.2 （-5.7-0.8） ml.min-1·1.73 m-2, respectively （Z = -2.408, P = 0.016）. There were no significant differences in adverse events between the groups. Conclusions： Niaoduqing particles safely and effectively delayed CKD progression in patients with stage 3b-4 CKD. This traditional Chinese medicine may be a promising alternative medication for patients with moderate-to-severe renal dysfunction.

The Ordos Basin is located in the east of NW China that is composed of different aquifer systems. Karst groundwater is stored in the Carmbrian-Ordovician carbonates along the margins of the basin. Fissured-pore water is present in the Cretaceous strata in the central-western basin and pore water is stored in the overlying Quaternary deposits discontinuously. The main origin of groundwater in the basin is direct or indirect infiltration of precipitation. Groundwater flows from recharge areas to adjacent local discharge areas. Besides evaporation and abstraction, groundwater feeds springs and rivers, such as the Yellow River and its tributaries. According to the karst aquifer lithologic structure, the features of karst development and circulation, the karst aquifer is divided into three structural and circulation patterns. Based on the control of Cretaceous sedimentary environment, lithologic structure, Uthofacies, and palaeogeographic characteristics, the Cretaceous system is divided into the northern desert simple plateau aquifer system and the southern loess plateau aquifer system. PACKER was used to obtain temperature, hydrogeochemical and isotope data at specific depths. Groundwater circulation is studied using hydrodynamic fields, temperature fields, isotopes, hydrogeochemical data and numerical simulations. According to the result, it is divided into local, intermediate and regional systems. The Ordos Basin contains a wealth of natural resources including coal, petroleum, oil shale and natural gas. There are four national-classenergy bases, e.g. northern Shaanxi energy basin, Inner Mongolia Ordos base, eastern Ningxia energy base, and Longdong base. And it is one of the most important bases for China＇s energy and heavy chemical industries. Because the basin is located in arid and semi-arid areas, the lack of water and its vulnerable ecological environment are the main limitations to the development of local economy and to the improvement of living standards. In order to assess the water resources and the utilization prospect and to provide the hydrological information for the establishment of the energy bases and economic development, groundwater investigation in the Ordos Basin has been carried out.

Background S100[beta] is a biomarker of astroglial damage, the level of which is significantly increased following brain injury. However, the characteristics of S100[beta] and its association with prognosis in patients with acute ischemic stroke following intravenous thrombolysis (IVT) remain unclear. Methods Patients in this multicenter prospective cohort study were prospectively and consecutively recruited from 16 centers. Serum S100[beta] levels were measured 24 h after IVT. National Institutes of Health Stroke Scale (NIHSS) and hemorrhagic transformation (HT) were measured simultaneously. NIHSS at 7 days after stroke, final infarct volume, and modified Rankin Scale (mRS) scores at 90 days were also collected. An mRS score [greater than or equal to] 2 at 90 days was defined as an unfavorable outcome. Results A total of 1072 patients were included in the analysis. The highest S100[beta] levels (> 0.20 ng/mL) correlated independently with HT and higher NIHSS at 24 h, higher NIHSS at 7 days, larger final infarct volume, and unfavorable outcome at 3 months. The patients were divided into two groups based on dominant and non-dominant stroke hemispheres. The highest S100[beta] level was similarly associated with the infarct volume in patients with stroke in either hemisphere (dominant: [beta] 36.853, 95% confidence interval (CI) 22.659-51.048, P < 0.001; non-dominant: [beta] 23.645, 95% CI 10.774-36.516, P = 0.007). However, serum S100[beta] levels at 24 h were more strongly associated with NIHSS scores at 24 h and 3-month unfavorable outcome in patients with dominant hemisphere stroke (NIHSS: [beta] 3.470, 95% CI 2.392-4.548, P < 0.001; 3-month outcome: odds ratio (OR) 5.436, 95% CI 2.936-10.064, P < 0.001) than in those with non-dominant hemisphere stroke (NIHSS: [beta] 0.326, 95% CI - 0.735-1.387, P = 0.547; 3-month outcome: OR 0.882, 95% CI 0.538-1.445, P = 0.619). The association of S100[beta] levels and HT was not significant in either stroke lateralization group. Conclusions Serum S100[beta] levels 24 h after IVT were independently associated with HT, infarct volume, and prognosis in patients with IVT, which suggests the application value of serum S100[beta] in judging the degree of disease and predicting prognosis. Keywords: S100[beta], Intravenous thrombolysis, Acute ischemic stroke, Outcome, Astroglial injury