Juan Wang

Background: Early discrimination between viral, bacterial, and mixed respiratory tract infections remains challenging in clinical practice. Conventional microbiological methods may be limited by turnaround time and specimen-related factors, whereas routine inflammatory markers lack sufficient specificity for etiological classification. We investigated whether flow cytometry-derived immune markers combined with C-reactive protein (CRP) could improve early infection stratification. Methods: In this prospective single-center study, adult patients with acute respiratory tract infection and healthy controls were enrolled between 29 July 2025 and 31 January 2026. Peripheral blood CD169 positivity on monocytes (CD169%), neutrophil CD64 index (nCD64 index), monocyte HLA-DR positivity (HLA-DR%), and CRP were measured and compared across viral infection (influenza A, influenza B, or COVID-19), bacterial infection, mixed infection, and healthy control groups. Logistic regression models were developed for three diagnostic tasks: viral versus bacterial infection, mixed versus bacterial infection, and mixed versus viral infection. Model performance was evaluated using receiver operating characteristic (ROC) analysis, DeLong testing, calibration, decision curve analysis (DCA), and bootstrap internal validation. Nomograms were constructed from the final models. Results: A total of 216 infected patients were included: 112 with viral infection, 67 with bacterial infection, and 37 with mixed infection; 50 healthy individuals served as controls. CD169% was increased in viral and mixed infection, whereas the nCD64 index was increased in bacterial and mixed infection. HLA-DR% was lower in bacterial infection. For differentiating viral from bacterial infection, the optimized three-marker model combining CD169%, nCD64 index, and CRP achieved an area under the ROC curve (AUC) of 0.8947 (95% CI: 0.8463–0.9432), with a sensitivity of 81.25% and a specificity of 80.70%. In mixed infection, CD169% was the main discriminator versus bacterial infection, while the nCD64 index and CRP were more informative versus viral infection. The combined model yielded an AUC of 0.7618 (95% CI: 0.6485–0.8751) for mixed versus bacterial infection and 0.8406 (95% CI: 0.7594–0.9218) for mixed versus viral infection. Longitudinal analyses showed that CD169% declined during recovery from viral infection, whereas the nCD64 index and CRP decreased after treatment in bacterial infection; all three markers declined in mixed infection. Conclusions: CD169%, the nCD64 index, and CRP reflect complementary dimensions of the host response to acute infection. Their combined assessment showed good performance for differentiating viral from bacterial infection and provided clinically relevant information in mixed infection. This host-response-based nomogram may serve as a practical adjunct for early etiological stratification and mixed-infection risk assessment.

Background: This study aims to investigate the electrocardiographic (ECG) alterations associated with hypercalcemia, focusing on characteristic T-wave alterations as potential diagnostic indicators. Methods: Utilizing a retrospective observational design, we analyzed ECG data from 64 hypercalcemic patients and a control group of 956 normocalcemic individuals. Results: Our findings reveal that 78.13% of hypercalcemic patients exhibited characteristic T-wave alterations, compared to only 14.64% in the control group (p < 0.001). Additionally, hypercalcemic patients demonstrated significantly shorter mean QT, QTc, and QTm intervals (QT: 340.5 ± 15.4 vs. 380.6 ± 75.5, QTc: 404.2 ± 78.4 vs. 415.7 ± 57.1, QTm: 226.6 ± 23.4 vs. 270.6 ± 27.0; all p < 0.01). Notably, the sensitivity, specificity, and accuracy of T-wave alterations for diagnosing hypercalcemia were 78.12%, 97.28%, and 96.08%, respectively, outperforming QT shortening (sensitivity: 48.43%, specificity: 76.99%). Conclusions: These results indicate that characteristic T-wave alterations are not only prevalent but also provide a reliable diagnostic tool for hypercalcemia, suggesting that integrating ECG analysis into routine clinical practice may enhance early detection and management of this condition.

Background： This study aims to investigate the electrocardiographic (ECG) alterations associated with hypercalcemia, focusing on characteristic T-wave alterations as potential diagnostic indicators. Methods：Utilizing a retrospective observational design, we analyzed ECG data from 64 hypercalcemic patients and a control group of 956 normocalcemic individuals. Results：Our findings reveal that 78.13% of hypercalcemic patients exhibited characteristic T-wave alterations, compared to only 14.64% in the control group (P < 0.001). Additionally, hypercalcemic patients demonstrated significantly shorter mean QT, QTc, and QTm intervals (QT: 340.5 ± 15.4 vs 380.6 ± 75.5, QTc: 404.2 ± 78.4 vs 415.7 ± 57.1, QTm: 226.6 ± 23.4 vs 270.6 ± 27.0; all P < 0.01). Notably, the sensitivity, specificity, and accuracy of T-wave alterations for diagnosing hypercalcemia were 78.12%, 97.28%, and 96.08%, respectively, outperforming QT shortening (sensitivity: 48.43%, specificity: 76.99%). Conclusions：These results indicate that characteristic T-wave alterations are not only prevalent but also provide a reliable diagnostic tool for hypercalcemia, suggesting that integrating ECG analysis into routine clinical practice may enhance early detection and management of this condition.

Aim: This study aimed to investigate the transcriptomic characteristics and interactions between competitive endogenous RNAs (ceRNAs) within small extracellular vesicles (sEVs) derived from mast ce... Plain language summary Mast cells (MCs) are important for various health conditions, including allergies, infections, tumors and brain disorders. MCs release tiny structures called small extracellu... Tweetable abstract Decoding mast cell messages: Explore the world of small extracellular vesicles (sEVs) and their genetic communication. Discover connections between lncRNAs, circRNAs and mRNAs in...

E22014 Background: Medical advances have been greatly improved in the five-year survival rate for Wilms’ tumor, but the survival is still dismal for relapsed/refractory (R/R) patients. In the present study, we aimed to investigate the genomic profiling and the incidence of germline cancer susceptibility mutationsof Chinese patients with R/R WT. Methods: Next-generation sequencing (NGS) of tumor specimens with matched blood samples obtained from R/R pediatric WT in Sun Yat-Sen University Cancer Center were used in a CAP-certified laboratory (Simcere Diagnostic Co, Ltd). Clinical information including age, gender and tumor histology were collected. Somatic and germline mutations including single nucleotide variants (SNV), insertion-deletion variants (Indels), copy number variations (CNVs) and fusion, as well as tumor mutational burden (TMB) were analyzed. Results: Nineteen patients with R/R WT were enrolled in this study, including 10 males and 9 females, with a median age of 4 years old (range, 0-14). All of the pathology was identified as favorable histology WT (FHWT). Somatic mutations were detected in 84.21% (16/19) of patients, and CNVs accounted for the majority of the total somatic aberrations, followed by SNVs. The most common somatic mutations were identified in the following genes, CTNNB1, ERBB2, MCL1, CDK2 and MDM4. Of the top 3 frequently mutated genes, the mutation frequency and their most common mutation type were CTNNB1, 26%, in-frame deletion, missense mutation; ERBB2 21%, missense mutation, amplification; MCL1 21%, amplification. It is worth noting that MCL1 mutation has never been reported in Chinese R/R WT patients before, which may be a potential valuable mechanism. Germline mutations were detected in 89.47% (17/19) of patients, and CNVs accounted for the majority of the total germline aberrations, followed by SNVs. The most common germline mutations were identified in the following genes, MCL1, RET, ALK, EPCAM, and FANCA. Of the top frequently mutated genes frequency and most common mutation type were MCL1 21%, amplification; RET 21% missense mutation, multiple mutations. There are also some suspected clinically pathogenic germline mutation of genes CDK4 , ERBB2, and MDM4. All the mutation type were amplification. Notable cancer driver mutations were also characterized, such as the amplifications of ERBB2/MET/EGFR/FGFR1, and the point mutations of CHEK2/FBXW7/NF1. The median TMB was 1.47 (range, 0-7.8). Conclusions: Overall, clinical and new results were detected in 14 (73.68%) in Chinese R/R WT patients. We discovered some driver genes mutations which potentially sensitive to the corresponding targeted drugs in Chinese R/R WT patients. Large sample size was needed to provide a better understanding of molecular features in R/R WT patients to achieve precision medicine.

Corrigendum: Identification and Validation Prognostic Impact of miRNA-30a-5p in Lung Adenocarcinoma

In situ-activated therapy is a decent option for localized diseases with improved efficacies and reduced side effects, which is heavily dependent on the local conversion or activation of bioinert components. In this work, we applied a phospholipid-mimic artemisinin prodrug (ARP) for preparing an injectable nano/microsphere to first realize an in situ-activated therapy of the typical systemically administrated artemisinin-based medicines for a localized rheumatoid arthritis (RA) lesion. ARP is simultaneously an alternative of phospholipids and an enzyme-independent activable prodrug, which can formulate “drug-in-drug” co-delivery liposomes with cargo of partner drugs (e.g., methotrexate). To further stabilize ARP/methotrexate “drug-in-drug” liposomes (MTX/ARPL) for a long-term intra-articular retention, a liposome-embedded hydrogel nano/microsphere (MTX/ARPL@MS) was prepared. After the local injection, the MTX/ARPL could be slowly released because of imine hydrolysis and targeted to RA synovial macrophages and fibroblasts simultaneously. ARP assembly is relatively stable before cellular internalization but disassembled ARP after lysosomal escape and converted into dihydroartemisinin rapidly to realize the effective in situ activation. Taken together, phospholipid-mimic ARP was applied for the firstly localized in situ-activated RA therapy of artemisinin-based drugs, which also provided a brand-new phospholipid-mimic strategy for other systemically administrated prodrugs to realize a remodeling therapeutic schedule for localized diseases.

Objective: To assess the detection performance of the hematopoietic stem cell enumeration kit developed by BD Biosciences. Methods: Cord blood samples were prepared using a hematopoietic stem cell enumeration kit developed by BD Biosciences and Stem-Kit reagents from Beckman Coulter. CD34+ cells were enumerated using a BD FACSCanto instrument and FACSDiva software. Results: A total of 519 samples were analyzed in this study. The hematopoietic stem cell enumeration kit developed by BD Biosciences yielded absolute counts of CD34-positive cells that were on average 8.7% lower than Beckman Coulter Stem-Kit reagents (range: −5.7% to−14.7%). The BD Biosciences kit yielded relative counts that were on average 9.9% higher compared with Beckman Coulter Stem-Kit reagents (range: −2.1% to +13.8%). The intraclass correlation coefficients for absolute and relative counts of CD34-positive cells were 0.9967 (95% confidence interval [CI]: 0.9961–0.9972) and 0.9512 (95% CI: 0.9423–0.9587) for the BD Biosciences and Beckman Coulter kits, respectively. Conclusions: The hematopoietic stem cell enumeration kit developed by BD Biosciences can be used to enumerate CD34-positive stem cells from cord blood samples.

Plant scientists and breeders strive to reduce poverty and undernourishment by increasing agricultural productivity and providing sufficient and nutritious food. The global human population is predicted to reach 10 billion by 2050, and crop production will need to be double that of 2005 (Tilman et al., 2011). However, agricultural productivity is faced with numerous constraints such as climate change, reduced arable land, and shortage of water resources. Therefore, there are increasing demands to generate new crop varieties with improved traits, such as disease resistance, stress tolerance, and efficient resource usage, in order to develop environmental-friendly sustainable agriculture, while maintaining high quality and nutrient-rich food for a better quality of life. To overcome these challenges, there is an urgent need to develop innovative and efficient crop breeding techniques to generate better varieties for increasing agricultural productivity.