Rationale aims and objectives: The study about disease profile in primary care are increasing, the evidence in China’s general medicine ward is insufficient. This study was analyzed characteristics among patients visited in general practice, to explore its influence to China’s medical transform. Method: we conducted a study about profile of general practice from Jan,2014 to Dec,2019 in The Second Affiliated hospital of Zhejiang Chinese Medical University, and records general practitioners’ routine work,including outpatient care,inpatient care and residency training. Results: In outpatient care,101689 patients consulted in GP’s clinic,these patients cover all age groups. Age group of 61-75 years reach the peak of consultations. Common chronic diseases are main causes of patients admitted in general practice,the top five causes of admissions are COPD, pneumonia, cerebrovascular disease, diabetes and complications, hypertension and complications. General practice in hospital also provides students residency training, 25undergraduates and a student with junior college degree passed the Practicing Physician Qualification Examination from 2015-2019. Conclusions: general practice in hospital alleviate some pressure of medical workforce,it has positive impact on China’s medical transform. KEYWORDS: general practice, general hospital,health transform

A semi-analytical study is presented for the thermophoretic migration of a spherical particle located at an arbitrary position in a porous medium inside a spherical cavity. A uniform applied temperature gradient parallel to the line connecting the particle and cavity centres. The porous medium is modeled as a Brinkman fluid with a characteristic Darcy permeability $K$ that can be obtained directly from the experimental data. The porous medium is assumed to be homogenous, isotropic and the solid matrix is in thermal equilibrium with the fluid through the voids of the medium. The Knudsen number is supposed to be small so that the fluid flow through the porous medium can be described by a continuum model with a temperature jump, a thermal creep, a frictional slip and thermal stress slip at the surface of the aerosol particle. The Reynolds number of the fluid is assumed to be small enough to justify the use of the Brinkman equation, which is always satisfied because the aerosol particle is so small. The P{\’e}clet number for heat transfer in thermophoresis is also assumed to be small. The dimensionless thermophoretic velocity and the mobility coefficients are tabulated and represented graphically for various values of the permeability parameter, relative thermal and surface properties of the particle and cavity. Results are in good agreement with the analytical solution of the particular case of a particle located at the centre of the cavity.

The article is concerned with the analytical solution to the integro-differential system of balance and kinetic equations that describe the crystal growth phenomenon in a binary system for various nucleation kinetics. The effect of impurity concentration on the evolutionary behavior of crystals is shown. The nonlinear dynamics of a supercooled binary melt is studied with allowance for the withdrawal mechanism of product crystals from a metastable liquid of the crystallizer.

The composition of founding populations plays an important role in colonisation dynamics and likely influences population growth during early stages of biological invasion. We tested the effects of founding population size (propagule size) and sex ratio on offspring production and annual population growth following experimental introductions of a non-native lizard species (Anolis sagrei). We manipulated propagule composition on nine small islands, then examined offspring production, population growth rate and survival rate of founders and their descendants encompassing four generations. By the third reproductive season, per capita offspring production was higher on islands seeded with a larger number of individuals. Population growth during the first year was negative on islands with male-biased propagules, but positive over the subsequent year, likely due to shifts in sex ratio. This study demonstrates that propagule size drives colonization dynamics in this species while male biases in propagule sex ratio may temporarily slow the invasion process.

Rheumatoid arthritis (RA) is a systemic inflammatory autoimmune disease that leads to joint destruction and disability. Despite a significant progress in administration of biological agents for RA patients, there is still a need for improved therapy. Intravenous-immunoglobulins (IVIG) , a pooled polyspecific immunoglobulin-G (IgG) extracted from 20,000 healthy subjects, showed beneficial therapeutic effect in patients with immune-deficiency, sepsis, and autoimmune diseases. The current study aim to investigate the beneficial effect of treatment with IVIG in established collagen induced arthritis in DBA/1j mice. Murine arthritis was induced in DBA/1j mice. The treatment with IVIG started when the disease was established. The clinical score was followed twice a week until day 48. The mice were bled for plasma, the paws were H&E stained. Cytokine profile in the plasma was analyzed by Luminex technology, titers of circulating anti-collagen antibodies in the plasma was tested by ELISA. Our results show that treatment with IVIG in murine, significantly rreduced the clinical arthritis score (P<0.001). Moreover, mode of action show that IVIG significantly reduced circulating level of inflammatory cytokines (IFN, IL-1β, IL-17, IL-6, TNFα) (P<0.001), inhibit anti-collagen antibodies (P < 0.001) in the plasma of CIA mice. Importantly, histopathological examination revealed that IVIG treatment prevented the migration of inflammatory immune cells into the cartilage and synovium, reduced the extent of joint damage and preserved joint architecture. Our results proved for the first time the valuable anti-inflammatory treatment of IVIG in experimental RA. We propose IVIG therapy for a subgroup of patients with as rheumatological-related diseases.

Multiple sclerosis (MS) is an autoimmune disease mediated by myelin autoantigen-specific T cells. Experimental autoimmune encephalomyelitis (EAE) induced by immunization of mice with a myelin oligodendrocyte glycoprotein (MOG) peptide emulsified in killed Mycobacterium tuberculosis-containing complete Freund’s adjuvant (CFA-EAE) is frequently used as a model of MS. Mycobacterium bovis BCG, a vaccine strain with various biological response modifier activity, has been reported to ameliorate clinical symptoms of the CFA-EAE although precise mechanism has not yet been documented. Since the CFA-EAE uses adjuvant with mycobacterial antigens, it is possible that mycobacterial antigen-specific T cells induced by CFA and those by therapeutic BCG inoculation recognize same antigens, and the cross-reactivity modulate the EAE. To exclude the influence of the cross-reactivity, we established a modified murine EAE model (CWS-EAE) which does not induce mycobacterial antigen-specific T cells. Inoculation of BCG 6 days after the CWS-EAE induction successfully ameliorated EAE symptoms, suggesting the therapeutic effects of BCG is independent of the mycobacterial antigen-specific T cells induced by CFA-EAE protocol. With the CWS-EAE model, we confirmed that induction of MOG-specific Th17 in the spleen and central nervous system (CNS) decreased with disappearance of demyelination lesions by the BCG inoculation. The amelioration of CNS pathology was not linked to changes in the number of macrophages, neutrophil and conventional dendritic cells (DC) but associated with decrease of plasmacytoid DC in CNS. The results suggest that BCG inoculation suppress both systemic and CNS Th17 response in the EAE mice and the mechanism may involve modulation of plasmacytoid DC.

Ice reserve estimates is a fundamental prerequisite for the water resources management, the upper Indus river basin (UIB) possesses the most abundant mid-latitude ice resources outside the poles. However, the ice reserve estimates remain unclear due to limited accessibility. We validated the critical parameters of the GlabTop2 model through ground-penetrating radar (GPR) measured ice thickness, compared the plots and profiles of the GPR-measured ice bed elevation versus GlabTop2-estimated results, integrated with GlabTop, Volta model, and the inverse distance weighted (IDW) interpolated results on various sized glaciers, a reasonable parametric scheme (τ =120 kPa and f = 0.8) of GlabTop2 was selected to apply on vast amounts of glaciers in the UIB region. GlabTop2 estimates indicated that the ice thickness of the UIB was varying from 0 to 488.1 m, with an average value of 74.4 m. Significant spatial heterogeneity exists in the sub-basins, Shyok, Shigar, and Hunza high-altitude sub-catchments own the most abundant ice reserve, less quantity was stored in the Western Himalaya and Hindukush ranges, which accounts for a small proportion (11.3% and 6.9%, respectively). A total of 1269.7 km3 ice volume can be converted to 1142.7 km3 water resources, and it can supply at least 16.1 y for the Besham hydrological station as runoff without considering the glacier process and other variables. The UIB relies on the glacier melting of the midstream because they are keeping in a self-sufficient state, in contrast, it will be up against water shortage in the future evenly, especially for the upper reaches and downstream area. Our estimates will provide the baseline information for water resources planning and management of the Indus river.

The report by Krishna MT and colleagues reveals some of the challenges clinicians face in the management of allergic diseases in the Indian subcontinent, especially with lack of availability of adrenaline auto-injectors, accessibility to validated in-vitro diagnostics, standardized allergens for skin testing and allergen immunotherapy products.

Objectives: The Heart Team (HT) approach plays a key role in selecting the optimal treatment strategy for patients with aortic stenosis. Little is known about the HT decision process and its impact on outcomes. The aim of this study was to identify the factors associated with the HT decision, and evaluate clinical outcomes according to the treatment choice. Methods: The study included a total of 286 consecutive patients with aortic stenosis referred for discussion in the weekly HT meeting in a cardiovascular institute over 2 years. Patients were stratified according to the selected therapeutic approach: medical treatment (MT), surgical (SAVR) or transcatheter (TAVR) aortic valve replacement. Baseline characteristics involved in making a therapeutic choice were identified and a decision-making tree was built using CART methodology. Results: Based on HT discussion 53 patients were assigned to SAVR, 210 to TAVR and 23 to MT. Older patients (≥88-years-old) were mainly assigned to TAVR or MT according to the Logistic EuroSCORE (< or ≥28, respectively). While among younger patients (<88 years), significant mitral regurgitation (≥grade III), frailty, STS score and estimated glomerular filtration rate were the most relevant factors influencing treatment allocation. One-year all-cause mortality was 16.6% in the invasive groups (TAVR 17.2%, SAVR 14.0%) and 68.7% in the MT arm. Conclusions: The HT decision was determined by well-recognized risk factors which were used to define a treatment decision algorithm. Future studies with younger and lower risk patients may identify new contributory factors which may alter the selection process and treatment choice.

Previous literature has proved that there exists a unique solution about multifactor uncertain differential equation (MUDE for short) when their coefficients satisfy strict global Lipschitz continuous condition. In this paper, firstly, we consider new existence and uniqueness theorem under the weaker local Lipschitz continuous condition. The next, when the coefficients do not satisfy the Lipschitz condition, we just showcase existence theorem under continuous and linear growth conditions. Once more, we establish the inverse uncertainty distributions (IUDs for short) of supremum, infimum and time integral about the uncertain process Zk, meanwhile, we design some numerical algorithms for solving these IUDs. In the end, some numerical examples are presented to verify the effectiveness of algorithms.

Objective: To compare the clinical course and outcomes of hospitalized pregnant and non-pregnant patients with coronavirus disease 2019 (COVID-19). Design: Retrospective, single centre and case-control study. Setting: Renmin Hospital of Wuhan University, Wuhan, Hubei province, China Population: SARS-CoV-2-infected hospitalized 31 pregnant and 124 non-pregnant patients diagnosed between 1 January 1 and 7 May, 2020; final date of follow-up was Jul 8, 2020. Main outcomes and measures: Demographic, clinical, laboratory, radiological, treatments and outcomes were collected, analyzed and compared between the two groups. All neonates received detection for SARS-CoV-2. Results: Pregnant patients had higher leucocytes, neutrophil counts, C-reactive protein and lactate dehydrogenase level, but lower lymphocyte counts. More pregnant patients received antibiotic, corticosteroids and oxygen support. All seventeen neonates had negative results of severe acute respiratory syndrome coronavirus (SARS-CoV-2) without complications. All 31 pregnant and 124 non-pregnant patients, with similar clinical symptoms, intensive care unit admission and complications, had been discharged. Conclusion: Pregnant patients might have more obvious inflammatory response, cellular immune deficiency and potential tissue necrosis, but similar clinical manifestations and outcomes as compared with the non-pregnant patients. No evidence of neonatal infections and complications had been shown in this study. Timely and active management may be beneficial for improving the outcomes of pregnant women with COVID-19 and the neonates. Keywords: Coronavirus Disease 2019; COVID-19; Severe Acute Respiratory Syndrome Coronavirus 2; SARS-CoV-2; Pregnant; Non-Pregnant. Tweetable abstract: Pregnant women had more obvious inflammatory response, cellular immune deficiency and potential tissue necrosis, but similar clinical manifestations and outcomes.

Background Enhanced recovery after surgery (ERAS), which originated in colorectal surgery, has been implemented in different types of surgery, but its effectiveness in gynaecologic surgery remains to be determined. Objectives A meta-analysis was conducted on the existing studies to compare the effects of ERAS pathways and routine management on the outcomes of gynaecological surgeries. Search Strategy The main database was retrieved from inception to 24 July 2020 using the term ‘enhanced recovery after surgery’ and its changes, as well as search restrictions for related study designs. Selection Criteria Studies whose number of ERAS pathways projects implemented by the ERAS group but not by the conventional surgery group was no less than four were included. Outcomes included length of hospital stay, complications, and so on. Data Collection and Analysis According to the accurate data extraction table, the fixed or random effects model was used to summarize. Main Results The length of hospital stay (LOS) situation of the ERAS group was significantly shorter than that of the control group, including the shortening of primary LOS (SMD=-0.681, 95% CI: -0.844–0.517, P<0.01) and total LOS (SMD=-0.312, 95% CI: -0.551–0.073, P=0.011), as well as the increase of the number of people reaching the target LOS (OR=4.899, 95% CI: 3.825-6.276, P<0.01). Conclusions The available evidence suggests that ERAS pathways may reduce the length of postoperative hospital stay in gynaecologic surgery, without increasing complications, while shortening the time needed for postoperative functional recovery. Keywords Enhanced recovery after surgery, ERAS, gynaecology

The relative influence of geography, oceanography and environment on gene flow within sessile marine species remains an open question. Detecting subtle genetic differentiation at small scales relevant to marine protected areas is challenging in benthic populations due to large effective population sizes, general lack of resolution in genetic markers, potential microbial associations, and because barriers to dispersal often remain elusive. We genotyped the sponge species Suberites diversicolor using double digest restriction-site associated DNA sequencing (4,826 Single Nucleotide Polymorphisms, SNPs), compared it to same individuals using single markers (COI and ITS), and used previously published data on the associated microbial communities from a subset of the same locations. Studying S. diversicolor from marine lakes at different spatial scales (1-1,400 km), along a gradient of connection to the surrounding sea, and with different environmental regimes, we did not detect strong effects of geographic distance, permeability of seascape barriers or local environments in shaping population genetic structure. All markers detected two major lineages and geographic clustering over a large spatial scale. However, with the SNP dataset we provide new evidence of strong population structure even at scales <10km (average FST = 0.56), where previously none was detected. A lack of congruence between host population structure and microbial community patterns of S. diversicolor from the same locations was observed, suggesting they are on different eco-evolutionary tracks. Our results call for a reassessment of poorly dispersing benthic organisms that were previously assumed to be highly connected based on low resolution markers.

Introduction Tachycardia-induced cardiomyopathy (TCM) is a reversible cause of heart failure with impaired left ventricle (LV) function. However, the diagnosis is difficult before treatment or control of the arrhythmia for the first time. This study was to clarify the characteristics of TCM with atrial fibrillation (AF) before AF ablation. Methods In this retrospective observational study, we observed 31 patients with paroxysmal or persistent AF who had impaired LV function without structural heart disease and who underwent catheter ablation. We defined impaired LV function as LV ejection fraction (LVEF) <50% on the initial or worst echocardiogram. After ablation, the LVEF became <60% (Group 1; n = 9) or ≧60% (Group 2; n = 22). We compared the differences in baseline characteristics between the two groups. A receiver operating curve with area under the curve (AUC) was used to evaluate the prediction efficiency. The optimal cutoff point of the AUC was at which sensitivity and specificity would be maximal. Results There were significant differences in left atrial (LA) volume (LAV) by computed tomography (CT), LAV adjusted by body surface area (LAVI) by CT, LAVI by echocardiography, and LA diameter (LAD) (p < 0.05, respectively). The AUCs were 0.859, 0.869, 0.798, and 0.750, respectively. The optimal cutoff points were 147 ml, 79 ml/m2, 37 ml/m2, and 45.8 mm, respectively. Conclusion Small LAV, LAVI by CT, LAVI by echocardiography, and LAD were predictors of LVEF improvement. Small LA volume and dimension before ablation may be useful for diagnosis of TCM with AF.

Background and Purpose: Bromodomain-containing protein 4 (BRD4) binds acetylated lysine residues on the N-terminal tails of histones through two bromodomains (BD1 and BD2) to regulate gene transcription. Inhibiting one or both of the bromodomains results in different phenotypes, suggesting BD1 and BD2 may have different functions. Here we report the characterization of a natural product 3’,4’,7,8-tetrahydroxyflavonoid as a new and potent BRD4 inhibitor with anti-cancer activities in vitro and in vivo. Experimental Approach: AlphaScreen assays were performed to evaluate the inhibitory activities of 3’,4’,7,8-tetrahydroxyflavonoid against the bromodomains. Crystal structures of the compound bound to BRD4-BD1 or BD2 were solved to reveal key binding features. MV4-11 in vitro cell culture model and xenograft mouse models were used to examine the compound’s anti-cancer activities. Western blotting, Immunofluorescence staining and RT-PCR were used to investigate the mechanism(s) of the compound in suppressing MV4-11 cell and tumor growth. Key Results: 3’,4’,7,8-tetrahydroxyflavonoid is ~100-fold more selective for BRD4-BD2 (IC50=204 nM) than BD1. Co-crystal structures show 3’,4’,7,8-tetrahydroxyflavonoid establishes more interactions in BRD4-BD2 acetylated lysine binding pocket than BD1. Consistent with a selective and high affinity with BRD4 bromodomains, 3’,4’,7,8-tetrahydroxyflavonoid treatment inhibited MV4-11 cell growth and reduced AML tumor growth in vitro and in vivo, respectively. Conclusion and Implications: Our data suggest 3’,4’,7,8-tetrahydroxyflavonoid as a potent selective inhibitor of BRD4-BD2 with a novel chemical scaffold. Given its distinct chemical structure from current BRD4 inhibitors, this compound may open the door for a novel class of BRD4 inhibitors by serving as a lead compound.

Background: Glucagon-like peptide-2 (GLP-2) is a 33 amino acid pro-glucagon-derived hormone produced in the intestinal enteroendocrine L-cells with trophic actions on both the gut and bones. GLP-2(1-33) is cleaved by the ubiquitous protease dipeptidyl peptidase-4 (DPP-4), resulting in GLP-2(3-33) with competitive antagonistic properties on the GLP-2 receptor (GLP-2R). Here we present two new hGLP-2 radioligands with different pharmacodynamic profiles. Experimental Approach: The methionine in position 10 of GLP-2(1-33) was substituted with tyrosine to enable oxidative iodination with incorporation of the iodine isotope [125I]. Similar substitution was done in GLP-2(3-33), thereby creating two new radioligands; an agonist [125]-hGLP-2(1-33,M10Y) and an antagonist [125]-hGLP-2(3-33,M10Y). Both were characterized regarding competition binding, binding kinetics and target tissue autoradiography. Key results: High and similar binding affinities for the human GLP-2R were observed for [125I]-hGLP-2(1-33,M10Y) and [125I]-hGLP-2(3-33,M10Y) with KD values of 59.3 nM and 40.6 nM, respectively. The M10Y substitution did not change the functional properties of GLP-2(1-33) or GLP-2(3-33). The antagonist [125I]-hGLP-2(3-33,M10Y) had higher Bmax and faster on-rate for the hGLP-2R compared to the agonist [125I]-hGLP-2(1-33,M10Y). Using autoradiography in mice strong labeling was observed in subepithelial myofibroblasts (SEMF) and pancreas islet cells. Both radioligands were selective for the GLP-2R, except for a low affinity binding to the GLP-1R (IC50 of 130 and 330 nM, respectively) Conclusion and implications: We successfully developed two new high affinity radioligands for GLP-2R studies and identified SEMF and pancreatic islets as target for GLP-2. It is uncertain whether binding in the pancreas islets results from GLP-2R or GLP-1R binding.

BACKGROUND Despite improvements in overall survival for pediatric cancers, treatment disparities remain for racial/ethnic minorities compared to non-Hispanic white; however, the impact of race on treatment outcomes for pediatric brain and central nervous system (CNS) tumors in the United States is not well known. METHODS We included 8713 children aged 0 – 19 years with newly diagnosed primary brain and CNS tumors between 2000 – 2015 from the Census Tract-level SES and Rurality Database developed by Surveillance, Epidemiology and End Results Program. We used Chi-square tests to assess differences in sociodemographic, cancer, and treatment characteristics by race/ethnicity and Kaplan–Meier curves and Cox proportional hazards models to examine differences in 10-year survival, adjusting for these characteristics. RESULTS Among 8,713 patients, 56.75% were non-Hispanic white, 9.59% non-Hispanic black, 25.46% Hispanic, and 8.19% from “other” racial/ethnic groups. Median unadjusted survival for all pediatric brain tumors was 53 months but varied significantly by race/ethnicity with a median survival of 62 months for Non-Hispanic whites, 41 months for Non-Hispanic blacks, and 40 months for Hispanic and Other. Multivariable analyses demonstrated minority racial groups still had significantly higher hazard of death than non-Hispanic whites; Hispanic [aHR 1.25 (1.18 - 1.31)]; non-Hispanic black [aHR 1.12(1.04 - 1.21)]; Other [aHR 1.22(1.12 - 1.32)]. Results were consistent when stratified by tumor histology. CONCLUSION We identified disparities in survival among racial/ethnic minorities with pediatric brain and CNS tumors, with Hispanic patients having the highest risk of mortality. Eliminating these disparities requires commitment towards promoting heath equity and personalized cancer treatment.

Gemtuzumab ozogamicin (GO) is an anti-CD33 antibody-tumor antibiotic conjugate with proven efficacy in pediatric and adult patients with CD33+ acute myeloid leukemia (AML). Adverse effects commonly associated with GO include hyperbilirubinemia, elevated transaminases, and sinusoidal obstruction syndrome (SOS). Cardiotoxicity has not been a commonly described adverse event. We describe two pediatric patients with relapsed/refractory AML who received fractionated GO monotherapy and subsequently developed severe acute left ventricular dysfunction. Both patients achieved remission, recovered cardiac function with medical therapy, and tolerated subsequent stem cell transplantation.

In the newly published article: “Medical algorithm: Diagnosis and treatment of radiocontrast media hypersensitivity” K. Brockow [1], suggested an algorithm for the evaluation of hypersensitivity to radiocontrast media (RCM). However, one important aspect has been left out of the suggested algorithm, the opportunity to desensitize patients with probable or confirmed immediate hypersensitivity reactions to radiocontrast media.  Especially those reacting to more than one substance. Desensitization to allergens is a standard preventative measure of anaphylaxis when patients have a history of severe immediate hypersensitivity reactions to a drug, and there are no therapeutic alternatives [2]. Protocols for RCM desensitization are known from case reports [3,4], and need more work and research before standardized protocols can be recommended, but they can facilitate the use of radiocontrast media in important situations such as the need for acute coronary angiograms. Such situations are rare, but an algorithm should include information and pathways to facilitate the best treatment possible for all patients. Suggested change in the algorithm is to include the option “rapid desensitization” in the pathway “RCM urgently needed without test possibility and indispensable need for the RCM”, and in the pathway for ”patients with confirmed RCM hypersensitivity with immediate hypersensitivity reactions to several RCM’s for situations with indispensable need for RCM”. This would help to facilitate the best point of care for more patients with hypersensitivity to RCM. Dr. Alnæs has nothing to disclose. Dr Alnæs is the only contributor to this article.  1.     Knut Brockow, Medical algorithm: Diagnosis and treatment of radiocontrast media hypersensitivity Allergy 2020 ;75:1278-1280. doi: 10.1111/all.14147. 2.     P. Demoly  N. F. Adkinson  K. Brockow et al. International Consensus on drug allergy, Allergy 2014; 69: 420-437.  https://doi.org/10.1111/all.123503.     Mona Al-Ahmada and Tito Rodriguez Bouzab ,Successful desensitization to radiocontrast media in two high-risk cardiac patients. Ann Saudi Med. 2017; 37(4): 333–335. doi: 10.5144/0256-4947.2017.333 4.     Saurav Uppal , Anthony E DeCicco , Anselma Intini  et al. Rapid Desensitization to Overcome Contrast Allergy Prior to Urgent Coronary Angiography. Int Heart J  2018; 30; 59(3):622-625. doi: 10.1536/ihj.17-395.

Abstract: Root rot leads to a significant decline in the production and quality of soybean, particularly in continuous cropping systems. Therefore, it is important to explore methods and mechanisms for the biocontrol of root rot pathogens. In this paper, the community structure of fungi in the root and rhizosphere soil was determined by high-throughput sequencing technology under non-inoculated and Funneliformis mosseae-inoculated conditions. Moreover, redundancy analysis (RNA) was used to analyse the effects of F. mosseae on the community structure of fungi and the physical and chemical properties of soil. In different samples (root and rhizosphere soil), the index of fungal diversity in HN48 was higher than that in HN66, while that without F. mosseae inoculation was slightly higher than that under inoculation with F. mosseae in different years of continuous cropping. Compared to non-inoculated plants, Fusarium oxysporum and Rhizoctonia solani were the dominant fungi in different root samples of soybean varieties. However, the predominant genera in the rhizosphere soil samples shifted with inoculation and comprised Fusarium, Mortierella, Cryptococcus, Guehomyces and Corynespora. Moreover, after inoculation with F. mosseae, the relative abundance of F. oxysporum and R. solani decreased in root and rhizosphere soils. Additionally, RDA showed that the rhizosphere soil had significant differences depending on F. mosseae inoculation, continuous cropping years, and soybean varieties. This study provides new insights into the interactive effects of arbuscular mycorrhizal fungi (AMF) and other fungi in continuously cropped soybean systems.

Background: The Coronavirus disease 2019 caused by SARS-CoV2 virus has rapidly spread worldwide becoming one of the most important challenges humans are facing nowadays. Risk factors for severe outcomes have been identified, but asthma seems not to be one of them. Objectives: To analyze lifestyle before the pandemic in severe pediatric asthma patients in treatment with a monoclonal antibody, belonging to Castellon’s Universitary General Hospital Health’s Department, and investigate the prevalence of COVID-19 in these patients in order to see if their lifestyle may have influenced the probability of being infected by COVID-19. Methods: A questionnaire was developed asking about: their lifestyle before the pandemic; suggestive COVID-19 symptoms and exposition to the disease; and patients’ behavior, asthma control and treatment during the pandemic. Total SARS-Cov-2 antibody tests were performed to all patients. Results: A total of 15 patients were included. All patients had a high social exposure before the pandemic. 2 patients had direct contact with positive COVID-19 patients. Both experienced mild symptoms that could be attributed to the disease, but neither of them had a positive serological test. Most patients followed asthma treatment correctly before and during the pandemic. 13 patients referred good asthma control. Most patients continued monthly monoclonal antibody administration. Serological tests were negative for all patients. Conclusion: Severe asthma pediatric patients in treatment with MAB, do not have an increased susceptibility for being infected by the virus, but in the case that they contracted the disease, evidence says they would have shown very weak symptoms.

Myriad faces of X-linked agammaglobulinemia in a young boyAuthors: Murugan Sudhakar1, Manpreet Arora1, Lesa Dawman1, Dharmagat Bhattarai1, Pratap Kumar Patra1, Ankur Kumar Jindal1, Ritambhra Nada2, Amit Rawat1, Karalanglin Tiewsoh1

Objectives: We aimed to compare the short- and mid-term results of perfusion strategies used for arch reconstruction surgery. Material and Methods: One hundred and seventy-three consecutive patients who underwent aortic arch reconstruction surgery for transverse arcus hypoplasia between January 2011 and February 2020 were retrospectively analyzed. The patients were divided into two groups, as beating heart group and cardiac arrest group. Results: The cardiac arrest group comprised 60 (35%) patients and the remaining 113 (65%) patients were in the beating heart group. The median age of the patients was 30 (IQR 18–95) days. The incidences of acute renal failure and delayed sternal closure were higher in the cardiac arrest group (P = 0.05,P < 0.001 respectively). Balloon angioplasty was performed in 5 (2%) patients and reoperation was performed in 11 (6%) patients due to restenosis. There were no statistically significant differences between the two groups in terms of reoperation or reintervention rates (P = 0.44 and 0.34, respectively). Conclusions: Both strategies were associated with satisfactory mid-term prevention of reintervention and reoperation. Given the lower incidence of acute renal failure and delayed sternal closure in the postoperative period and similar mid-term outcomes, we believe that the beating heart strategy is preferable.

Aim: We aimed to present the patients who had COVID-19 infiltrations incidentally detected in the lung basal sections in patients with abdomen CT due to flank pain in the urology outpatient clinic during the pandemic process. Methods: A total of 276 patients admitted to the Siirt Training and Research Hospital Urology outpatient clinic between March 15, 2020, and August 09, 2020, with a complaint of flank pain and underwent non-contrast abdomen CT were analyzed from this data retrospectively. A total of 10 patients with Covid-19 compatible findings in CT were determined as the study group. A control group was formed from 10 patients with only urological pathologies (kidney stones, ureteral stones, hydronephrosis … etc) without Covid-19 compatible appearance on CT. Results: Ten (3.6%) patients with COVID-19 disease pneumonic infiltrations were detected in the lung basal regions entering the abdomen CT cross-section. The visual analog scale (VAS) score was higher in the control group, who had urological pathology and did not have Covid-19 findings in the lung bases in abdominal CT, and it was statistically significant. During the admission to the urology outpatient clinic, there were no signs of COVID-19 disease such as fever, cough, and shortness of breath. Conclusion: If the severity of pain is not very high in patients who apply to urology outpatient clinics with flank pain during the pandemic period, and if no urological pathology is observed in the Abdomen CT, Covid-19 should be kept in mind in the differential diagnosis.