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Since the outbreak of Coronavirus Disease 2019 (COVID-19) in December 2019, various digestive symptoms have been frequently reported in patients infected with the virus. In this study, we aimed to further investigate the prevalence and outcomes of COVID-19 patients with digestive symptoms. In this descriptive, cross-sectional, multicenter study, we enrolled confirmed patients with COVID-19 who presented to 3 hospitals from January 18, 2020, to February 28, 2020. All patients were confirmed by real-time polymerase chain reaction and were analyzed for clinical characteristics, laboratory data, and treatment. Data were followed up until March 18, 2020. In the present study, 204 patients with COVID-19 and full laboratory, imaging, and historical data were analyzed. The average age was 52.9 years (SD ± 16), including 107 men and 97 women. Although most patients presented to the hospital with fever or respiratory symptoms, we found that 103 patients (50.5%) reported a digestive symptom, including lack of appetite (81 [78.6%] cases), diarrhea (35 [34%] cases), vomiting (4 [3.9%] cases), and abdominal pain (2 [1.9%] cases). If lack of appetite is excluded from the analysis (because it is less specific for the gastrointestinal tract), there were 38 total cases (18.6%) where patients presented with a gastrointestinal-specific symptom, including diarrhea, vomiting, or abdominal pain. Patients with digestive symptoms had a significantly longer time from onset to admission than patients without digestive symptoms (9.0 days vs 7.3 days). In 6 cases, there were digestive symptoms, but no respiratory symptoms. As the severity of the disease increased, digestive symptoms became more pronounced. Patients with digestive symptoms had higher mean liver enzyme levels, lower monocyte count, longer prothrombin time, and received more antimicrobial treatment than those without digestive symptoms. We found that digestive symptoms are common in patients with COVID-19. Moreover, these patients have a longer time from onset to admission, evidence of longer coagulation, and higher liver enzyme levels. Clinicians should recognize that digestive symptoms, such as diarrhea, are commonly among the presenting features of COVID-19 and that the index of suspicion may need to be raised earlier in at-risk patients presenting with digestive symptoms. However, further large sample studies are needed to confirm these findings.

ASXL1 mutations are frequently found in hematological tumors, and loss of Asxll promotes myeloid transforma- tion in mice. Here we present data supporting a role for an ASXL1-BAP1 complex in the deubiquitylation of mono-ubiquitinylated lysine 119 on Histone H2A （H2AK119ubl） in vivo. The Polycomb group proteins control the expression of the INK4B-ARF-INK4A locus during normal development, in part through catalyzing mono-ubiquit- inylation of H2AK119. Since the activation of the locus INK4B-ARF-INK4A plays a fail-safe mechanism protecting against tumorigenesis, we investigated whether ASXLl-dependent H2A deubiquitylation plays a role in its activation. Interestingly, we found that ASXL1 is specifically required for the increased expression of p15INa4n in response to both oncogenic signaling and extrinsic anti-proliferative signals. Since we found that ASXL1 and BAP1 both are enriched at the INK4B locus, our results suggest that activation of the INK4B locus requires ASXL1/BAPl-mediated deubiqui- tylation of H2AK119ubl. Consistently, our results show that ASXL1 mutations are associated with lower expression levels of p151NK4B and a proliferative advantage of hematopoietic progenitors in primary bone marrow cells, and that depletion of ASXL1 in multiple cell lines results in resistance to growth inhibitory signals. Taken together, this study links ASXLl-mediated H2A deubiquitylation and transcriptional activation of INK4B expression to its tumor sup- pressor functions.

Frontline healthcare nurses devoted themselves to deal with the outbreak of COVID-19, saving many lives. However, they are under incredible unknown psychological pressures with a considerable risk of infection. In this study, a self-administered questionnaire was used to survey 593 frontline nurses in Wuhan City and non-Hubei provinces for psychological responses from March 1 to March 10, 2020. Compared with nurses outside Hubei Province, those working in Wuhan were more likely to feel physically and mentally exhausted. Their probable depression and anxiety were significantly higher than those of nurses outside Hubei province (31.2%, 18.3% vs. 13.8%, 5.9%). Correspondingly, the depressive symptoms were more often reported in the Wuhan group (70.8% vs. 41.4%). Although Wuhan received wishes, concerns, and abundant psychological and material resources from all of the world, the survey-based study found that frontline nurses in Wuhan still had higher depression and anxiety with less social support compared with nurses from non-Hubei provinces. Unexpectedly, only 4.0% of nurses have sought psychological assistance. These findings suggested that the short-term psychological impact of frontline nurses in Wuhan during the COVID-19 outbreak was extremely high compared with nurses outside Hubei Province. This research enlightened the efficient integration of psychological resources, the optimization of the nurse emergency psychological assistance system, and the mental health care of medical staff during the outbreak of epidemics.

The COVID-19 pandemic is a significant global event in the history of infectious diseases. The SARS-CoV-2 appears to have originated from bats but is now easily transmissible among humans, primarily through droplet or direct contact. Clinical features of COVID-19 include high fever, cough, and fatigue which may progress to ARDS. Respiratory failure can occur rapidly after this. The primary laboratory findings include lymphopenia and eosinopenia. Elevated D-dimer, procalcitonin, and CRP levels may correlate with disease severity. Imaging findings include ground-glass opacities and patchy consolidation on CT scan. Mortality is higher in patients with hypertension, cardiac disease, diabetes mellitus, cancer, and COPD. Elderly patients are more susceptible to severe disease and death, while children seem to have lower rates of infection and lower mortality. Diagnostic criteria and the identification of persons under investigation have evolved as more data has emerged. However, the approach to diagnosis is still very variable from region to region, country to country, and even among different hospitals in the same city. The importance of a clinical pathway to implement the most effective and relevant diagnostic strategy is of critical importance to establish the control of this virus that is responsible for more and more deaths each day.

Designing and making sustainable plastics is especially urgent to reduce their ecological and environmental impacts. However, it remains challenging to construct plastics with simultaneous high sustainability and outstanding comprehensive performance. Here, a composite strategy of in situ polymerizing a petroleum‐based monomer with the presence of an industrialized bio‐derived polymer in a quasi‐solvent‐free system is introduced, affording the plastic with excellent mechanical robustness, impressive thermal and solvent stability, as well as low energy, consumes during production, processing, and recycling. Particularly, the plastic can be easily processed into diverse shapes through 3D printing, injection molding, etc. during polymerization and further reprocessed into other complex structures via eco‐friendly hydrosetting. In addition, the plastic is mechanically robust with Young's modulus of up to 3.7 GPa and tensile breaking strength of up to 150.2 MPa, superior to many commercially available plastics and other sustainable plastics. It is revealed that hierarchical hydrogen bonds in plastic predominate the well‐balanced sustainability and performance. This work provides a new path for fabricating high‐performance sustainable plastic toward practical applications, contributing to the circular economy. Sustainable plastic is achieved with excellent mechanical robustness, impressive thermal and solvent stability as well as low energy consumption during production, processing, and recycling. The plastic can be easily processed into diverse shapes via 3D printing, injection molding, hydrosetting, etc. Meanwhile, the plastic shows E up to 3.7 GPa and σb up to 150.2 MPa, superior to many commercially available plastics and other sustainable plastics.

Background At present, there are several diagnostic criteria of sarcopenia were used in China, and the diagnostic criteria were not unified. This study aims to investigate the consistency between the latest sarcopenia diagnostic criteria Asian Working Group for Sarcopenia(AWGS 2019) and other common diagnostic criteria. The changes of muscle mass, muscle strength and physical function with age and their effects on the diagnosis of sarcopenia were also analyzed. Methods A total of 1009 men aged ≥60 years were enrolled from multiple communities. Skeletal muscle mass index, grip strength and 6 m gait speed were measured. The consistency of AWGS 2019 with other diagnostic criteria was analyzed and the trends of these three indicators were observed. The differences of muscle mass, muscle strength and function among different diagnostic criteria and age groups were evaluated. In addition, the change trends of these three indicators with age were observed. Results According to AWGS 2019 diagnostic criteria, the incidence of sarcopenia in male aged 60–69 years, 70–79 years and over 80 years was 1.5%, 9.6% and 33.1%, respectively. AWGS 2019 was highly consistent with other diagnostic criteria ( Kappa  = 0.66–0.80, P  < 0.01), except the Foundation for the National Institutes of Health(FNIH) ( Kappa  = 0.32, P  < 0.01). When AWGSA2019 diagnostic criteria are applied, the prevalence of decreased muscle strength (39.1%) and physical function (46.4%) was significantly higher than that of low muscle mass (35.9%) in the men over 80 years old. Muscle strength ( P  < 0.01) and function ( P  < 0.01) decreased at the same rate with age, both of which were more significant than muscle mass ( P  < 0.01). Conclusion AWGS 2019 was highly consistent with other criteria. Maintaining muscle mass should be the focus of attention before age 80, while improving muscle strength and function should be focused after age 80 to prevent disability.

Background The clinical treatment of long bone defets in the extremities caused by trauma, infection, tumours, and nonunion has been a challenge for orthopaedic surgeons. Bone transport techniques have become the only way to treat such bone defects. However, inevitable difficulties and complications related to bone transport techniques have been reported in many studies. Aim The purpose of this study was to investigate the risk factors for complications and the effectiveness of the Ilizarov bone transport technique in the treatment of tibial bone defects. Methods The study was conducted in 199 patients who underwent treatment with the Ilizarov bone transport technique at our institution from May 2012 to September 2019. Patient demographic data, complications and clinical outcomes after a minimum of 2 years of follow-up were collected and retrospectively analysed. Additionally, a risk factor analysis was performed for the top three major complications. The clinical outcomes were evaluated using the Association for the Study and Application of the Method of Ilizarov (ASAMI) criteria at the last clinical follow-up. Results A total of 199 patients underwent follow-up for 12–40 months, with an average of 23.5 months, and all achieved bone healing. A total of 310 complications occurred, with an average of 1.04 minor complications and 0.48 major complications per patient. The top three complications were pin tract infection in 48 cases (61.3%), axial deviation in 86 cases (43.2%), and delayed union in 50 cases (25.13%). Multivariate analysis showed that the bone defect length ( P =  0.02, OR  = 5.489), the number of previous surgeries ( P =  0.003, OR  = 2.204), and the external fixation index ( P =  0.01, OR  = 1.202) were significantly correlated with pin tract infection. Bone defects of the middle 1/3 ( P  < 0.001, OR  = 23.769), the bone defect length ( P  < 0.001, OR  = 2.776), and the external fixation index ( P  < 0.001, OR  = 1.154) were significantly correlated with axial deviation. The bone defect length ( P =  0.003, OR  = 1.242), soft tissue defects ( P =  0.013, OR  = 0.312) and bone defects of the distal 1/3 ( P =  0.023, OR  = 4.257) were significantly correlated with delayed healing. The ASAMI bone score at the last follow-up showed a rate of excellent and good bone results of 95.48% and a rate of excellent functional results of 87.94%. Conclusion The Ilizarov bone transfer technique is an effective method for treating tibial bone defects, and shortening the treatment period can reduce the incidence of complications. Older patients and those with longer bone defects, a higher external fixation index, more previous operations, and defects of the middle and distal 1/3 had a higher incidence of complications.

Ferroptosis of type II alveolar epithelial (AT2) cells plays a crucial role in the pathological progression of acute lung injury (ALI). Although fibroblast growth factor-2 (FGF2) has been shown to exert protective effects against ALI, the underlying mechanisms remain largely unexplored. The present study investigated the relationship between ferroptosis and FGF2 in the pathogenesis of ALI. Our study found that FGF2 administration mitigated lung pathology, respiratory dysfunction, inflammation, and oxidative stress induced by lipopolysaccharide (LPS). Conversely, genetic knockout of FGF2 exacerbated lung injury, inflammation, oxidative stress, and ferroptosis. RNA sequencing and bioinformatics analyses identified ferroptosis as a key target of FGF2-mediated protection. Pharmacological induction of ferroptosis negated the protective effects of FGF2 on AT2 cells. Mechanistically, co-immunoprecipitation assays revealed that FGF2 suppressed ferritinophagy-associated changes by disrupting the interaction between NCOA4 and FTH1. Further investigation revealed that FGF2 modulated this interaction via the Hippo-YAP signaling pathway. Collectively, these results underscored the therapeutic potential of targeting the FGF2-mediated suppression of ferritinophagy-induced ferroptosis in treating LPS-induced ALI.

To develop battery-supercapacitor hybrid devices with high energy and power densities, we propose a rational design of a quaternary hybrid superstructure by using a high-energy biotemplate. This new superstructure is composed of stable fullerene C60 nanocages, electroactive Na4FeO3, high-energy Li3V2(PO4)3 and soft carbon as well as tubular ordered mesoporous channels. This design takes advantage of the unique properties of each component, resulting in nanocomposites with synergistic effects to improve the charge transfer and energy storage. We found that this quaternary hybrid electrode has both high energy and power densities as well as a long cycling life in a Li/Na mixed-ion electrolyte, outperforming a multitude of other battery-supercapacitor hybrid devices reported thus far. The charge storage mechanisms of this hybrid superstructure are proposed for optimizing the electrode design.Energy storage: Combining the best of batteries and supercapacitorsAn energy-storage device that has the advantages of both batteries and supercapacitors has been developed by researchers in China and Sweden. Batteries can store a lot of energy in a small space: they have a high energy density. Supercapacitors, on the other hand, can be more quickly charged and discharged: they have a high power density. Wen He from the Qilu University of Technology in Jinan, Jiefang Zhu from Uppsala University and their colleagues have created a hybrid energy-storage device that has both high energy density and high power density. Their device uses a wide range of different materials combining carbon nanocages, soft carbon, and the electroactive material Na4FeO3. This design takes advantage of the unique properties of each component, resulting in improved charge transfer and energy storage.