[One-stage revision for reconstructing acetabular defects by trabecular metal acetabular revision system in periprosthetic joint infection].

Objective: To investigates the clinical efficacy of the trabecular metal acetabular revision system (TMARS) in one-stage reconstruction of acetabular deficiencies associated with periprosthetic joint infection (PJI). Methods: This is a retrospective case series study,including the data of 59 patients with PJI underwent acetabular defect reconstruction by TMARS during one-stage revisions in the Department of Joint Surgery,the First Affiliated Hospital of Xinjiang Medical University from January 2013 to December 2021. There were 32 males and 27 females, aged (59.5±14.6) years (range: 26 to 84 years). Among them, 29 cases used tantalum cups, 13 cases used tantalum cups and tantalum reinforcing blocks, 9 cases used cup-cage, and 8 cases used multi-cup reconstruction techniques. The surgery procedure, Harris Hip score (HHS), recovery of the hip rotation center, implant survival rate, postoperative reinfection rate, and complications were recorded. Data were compared using the Wilcoxon rank-sum test. Results: All of the 59 patients underwent the operations successfully. Operation time was (188.9±48.4) minutes (range: 110 to 340 minutes), and intraoperative bleeding volume was (M(IQR)) 1 000(400) (range: 600 to 1 800 ml). After a postoperative follow-up of 5.1 (2.6) years (range: 2.0 to 10.5 years), the prosthesis survival rate was 94.9% (56/59). Recurrence of infection occurred in 3 cases (5.1%), aseptic loosening in 1case(1.7%), and hip dislocation in 4 cases (6.8%). At the last follow-up, HHS improved significantly(84 (12) vs. 44 (9), Z=-6.671, P<0.01), and the center of rotation of the hips were recovered in all cases. Conclusions: In one-stage revision surgeries aimed at reconstructing acetabular defects, utilizing the TMARS can provide stable initial fixation, restore a more natural center of rotation, significantly enhance early postoperative hip joint function, and reduce the likelihood of infection recurrence. This approach stands as a reliable choice for addressing acetabular defects during revision surgeries for infected hip joints.

Comparison of His-Purkinje Conduction System Pacing with Atrial-Ventricular Node Ablation and Pharmacotherapy in HFpEF Patients with Recurrent Persistent Atrial Fibrillation (HPP-AF study).

BACKGROUND: There is currently no particularly effective strategy for patients with persistent atrial fibrillation accompanying heart failure with preserved ejection fraction (HFpEF), especially with recurrent atrial fibrillation after ablation. In this study, we will evaluate a new treatment strategy for patients with persistent atrial fibrillation who had at least two attempts (≧2 times) of radio-frequency catheter ablation but experienced recurrence, and physiologic conduction was reconstructed after atrioventricular node ablation or drug therapy, to control the patient's ventricular rate to maintain a regular heart rhythm, which is called His-Purkinje conduction system pacing (HPCSP) with atrioventricular node ablation. METHODS AND RESULTS: This investigator-initiated, multicenter prospective randomized controlled trial aimed to recruit 296 randomized HFpEF patients with recurrent atrial fibrillation. All the enrolled patients were randomly assigned to the pacing group or the drug treatment group. The primary endpoint is differences in cardiovascular events and clinical composite endpoints (all-cause mortality) between patients in the HPCSP and drug-treated groups. Secondary endpoints included heart failure hospitalization, exercise capacity assessed by cardiopulmonary exercise tests, quality of life, echocardiogram parameters, 6-minute walk distance, NT-ProBNP, daily patient activity levels, and heart failure management report recorded by the CIED. It is planned to compete recruitment by the end of 2023 and report in 2025. CONCLUSIONS: The study aims to determine whether His-Purkinje conduction system pacing with atrioventricular node ablation can better improve patients' symptoms and quality of life, postpone the progression of heart failure, and reduce the rate of rehospitalization and mortality of patients with heart failure. CLINICAL TRIAL REGISTRATION NUMBER: ChiCTR1900027723, URL: http://www.chictr.org.cn/edit.aspx?pid=46128&htm=4.

The effect of glutathione biosynthesis of Streptococcus thermophilus ST-1 on cocultured Lactobacillus delbrueckii ssp. bulgaricus ATCC11842.

Streptococcus thermophilus and Lactobacillus delbrueckii ssp. bulgaricus are the main species used for yogurt preparation. Glutathione (GSH) can be synthesized by S. thermophilus and plays a crucial role in combating environmental stress. However, the effect of GSH biosynthesis by S. thermophilus on cocultured L. delbrueckii ssp. bulgaricus is still unknown. In this study, a mutant S. thermophilus ΔgshF was constructed by deleting the GSH synthase. The wild strain S. thermophilus ST-1 and ΔgshF mutants were cocultured with L. delbrueckii ssp. bulgaricus ATCC11842 by using Transwell chambers (Guangzhou Shuopu Biotechnology Co., Ltd.), respectively. It was proven that the GSH synthesized by S. thermophilus ST-1 could be absorbed and used by L. delbrueckii ssp. bulgaricus ATCC11842, and promote growth ability and stress tolerance of L. delbrueckii ssp. bulgaricus ATCC11842. The biomass of L. delbrueckii ssp. bulgaricus ATCC11842 cocultured with S. thermophilus ST-1 or ΔgshF (adding exogenous GSH) increased by 1.8 and 1.4 times compared with the biomass of L. delbrueckii ssp. bulgaricus ATCC11842 cocultured with S. thermophilus ΔgshF. Meanwhile, after H2O2 and low-temperature treatments, the bacterial viability of L. delbrueckii ssp. bulgaricus cocultured with S. thermophilus ΔgshF, with or without GSH, was decreased by 41 and 15% compared with that of L. delbrueckii ssp. bulgaricus cocultured with S. thermophilus ST-1. Furthermore, transcriptome analysis showed that the expression levels of genes involved in purine nucleotide and pyrimidine nucleotide metabolism in L. delbrueckii ssp. bulgaricus ATCC11842 were at least 3 times increased when cocultured with S. thermophilus (fold change > 3.0). Moreover, compared with the mutant strain ΔgshF, the wild-type strain ST-1 could shorten the fermented curd time by 5.3 hours during yogurt preparation. These results indicated that the GSH synthesized by S. thermophilus during cocultivation effectively enhanced the activity of L. delbrueckii ssp. bulgaricus and significantly improved the quality of fermented milk.

Application of acoustic spectroscopy and neural networks to on-line size measurement of pharmaceutical nanocrystals.

Acoustic spectroscopy and neural networks (NNs) are applied to on-line real-time measurement of particle size distribution (PSD) during wet milling of pharmaceutical nanocrystals. A method for modeling the relationship between acoustic attenuation spectra and PSD is proposed that is based on NNs and principal component analysis (PCA). PCA reduces the dimensions of both the spectra and the PSD; then, a neural network model of 2 × 2 × 2 (input, hidden, output layer nodes) with only eight connection weights is built. Compared with previous instrument models that could require as many as 14 physical properties, the current approach does not need any prior knowledge of the system's properties. In addition, the time taken to complete a PSD measurement is reduced from minutes to seconds and it always generates a single solution, rather than possible multiple PSD solutions as in early methods. Application to hydrotalcite nanomilling found good agreement between the on-line measurements and off-line analysis.

The economic burden of coronary heart disease in mainland China.

OBJECTIVES: The aim of this study was to systematically evaluate the current economic burden of coronary heart disease (CHD) in mainland China and provide a reference for the formulation of policies to reduce the economic burden of CHD. STUDY DESIGN: A systematic literature review was conducted of empirical studies on the economic burden of CHD over the past 20 years. METHODS: PubMed, Web of Science, Embase, China Knowledge Resource Integrated Database and the WANFANG database were comprehensively searched for relevant articles published between 1 January 2000 and 22 December 2021. Content analysis was used to extract the data, and Stata 17.0 software was used for analysis. The median values were used to describe trends. RESULTS: A total of 35 studies were included in this review. The annual median per-capita hospitalisation expense and the average expense per hospitalisation were $3544.40 ($891.64-$18,371.46) and $5407.34 ($1139.93-$8277.55), respectively. The median ratio on medical consumables expenses, drug expenses, medical examination expenses and treatment expenses were 41.59% (12.40%-63.73%), 26.90% (7.30%-60.00%), 9.45% (1.65%-33.40%) and 10.10% (2.36%-66.00%), respectively. The median per-capita hospitalisation expense in the eastern, central and western regions were $9374.45 ($2056.13-$18,371.46), $4751.5 ($2951.95-$8768.93) and $3251.25 ($891.64-$13,986.38), respectively. The median average expense per hospitalisation in the eastern and central regions were $6177.15 ($1679.15-$8277.55) and $1285.49 ($1239.93-$2197.36), respectively. The median average length of stay in the eastern, central and western regions were 9.3 days, 15.2 days and 16.1 days, respectively. CONCLUSIONS: The economic burden of CHD is more severe in mainland China than in developed countries, especially in terms of the direct economic burden. In terms of the types of direct medical expenses, a proportion of medical examination expenses, treatment expenses and drug expenses were lowest in the eastern region, but medical consumables expenses were the highest in this region. This study provides guidance for the formulation of policies to reduce the economic burden of CHD in mainland China.

Investigation on knowledge level about rational use of antimicrobial drugs among pharmacists in medical institutions in Shanxi province, China.

OBJECTIVE: To investigate the pharmacist's knowledge about rational use of antimicrobials in Shanxi of China, so as to find out the problems and provide support for the management of antimicrobials. METHODS: A questionnaire survey was conducted, which included the basic information of the respondents, the basic knowledge about antimicrobial management and the related knowledge about antimicrobial drugs. SPSS 25.0 was used for statistical analysis. RESULTS: A total of 462 pharmacists were investigated. The average score of the knowledge related to rational use of antimicrobials was 10.49 ± 4.05. It showed that the hospital type, grade, pharmacist's education, professional title and years of experience had effect on the pharmacist's knowledge level about antimicrobial drugs (P < 0.05). Multivariable logistic regression analysis showed that hospital grade and pharmacist's education were the main influencing factors (P < 0.05). CONCLUSION: Pharmacists have insufficient knowledge about the rational use of antibacterial drugs. It is essential to strengthen the training in management regulations and application of antibacterial drugs.

[Analysis of prognosis factors of postoperative cardiac complications in colorectal cancer patients with comorbid coronary artery disease].

Objective: To examine the prognosis factors of postoperative cardiac complications in colorectal cancer patients co-morbidated with coronary artery disease. Methods: Clinical data of 449 patients colorectal cancer patients co-morbidated with coronary artery disease accepted redical surgery from April 2013 to April 2020 at Department of General Surgery, Peking Union Medical College Hospital were analyzed retrospectively. There were 306 males and 143 females, aging (68.7±8.9) years (range: 44 to 89 years). Postoperative acute coronary syndrome, new-onset arrhythmia and heart failure that causes clinical symptoms were recorded as cardiac complications. t test, χ2 test and Fisher exact test were used for univariate analysis of prognosis factors of postoperative cardiac events. The variables with P<0.05 were included in the multivariate Logistic regression was used to determine the independent prognosis factors. Results: After surgery, 44 patients (9.8%) suffered from at least one cardiac event, including 30 patients with acute coronary syndrome, 19 patients with new-onset arrhythmia and 9 patients with heart failure. There were 3 deaths in the cohort within 30 days after surgery. Two patients died from cardiac-related complications, and one from septic shock due to postoperative anastomotic leaks. On Univariate analysis showed that cardiac complications were associated with age ≥80 years, co-morbidated diabetes, emergency surgery, re-operation, anastomotic leakage, intestinal flora disorder and elevation of preoperative neutrophil-lymphocyte ratio (χ2: 4.308 to 12.219, all P<0.05). Multivariate Logistic regression analysis identified age ≥80 years(OR=3.195, 95%CI: 1.379 to 7.407, P=0.007), co-morbidated diabetes (OR=2.551, 95%CI: 1.294 to 5.025, P=0.007), emergency surgery (OR=4.717, 95%CI: 1.052 to 20.833, P=0.043), and elevated preoperative neutrophil-lymphocyte ratio (OR=1.114, 95%CI: 1.018 to 1.218, P=0.018) as independent prognosis factors for cardiac complications. Conclusions: Emergency surgery, advanced age, co-morbidated type 2 diabetes and elevated preoperative neutrophil-lymphocyte ratio may increase the risk of postoperative cardiac complications in colorectal cancer patients with coronary artery disease. Surgeons should strictly master surgical indications, pay attention to preoperative assessment, perioperative monitoring, and diagnosis and treatment of postoperative complications in order to reduce the risk of complications.

Excited-State Switching in Rhenium(I) Bipyridyl Complexes with Donor-Donor and Donor-Acceptor Substituents.

The optical properties of two Re(CO)3(bpy)Cl complexes in which the bpy is substituted with two donor (triphenylamine, TPA, ReTPA2) as well as both donor (TPA) and acceptor (benzothiadiazole, BTD, ReTPA-BTD) groups are presented. For ReTPA2 the absorption spectra show intense intraligand charge-transfer (ILCT) bands at 460 nm with small solvatochromic behavior; for ReTPA-BTD the ILCT transitions are weaker. These transitions are assigned as TPA → bpy transitions as supported by resonance Raman data and TDDFT calculations. The excited-state spectroscopy shows the presence of two emissive states for both complexes. The intensity of these emission signals is modulated by solvent. Time-resolved infrared spectroscopy definitively assigns the excited states present in CH2Cl2 to be MLCT in nature, and in MeCN the excited states are ILCT in nature. DFT calculations indicated this switching with solvent is governed by access to states controlled by spin-orbit coupling, which is sufficiently different in the two solvents, allowing to select out each of the charge-transfer states.

Hepatitis C virus core antigen as alternative diagnostic algorithm for active hepatitis C virus infection among haemodialysis population: Cost implications.

AIMS: In Malaysia, majority anti-HCV positive haemodialysis patients do not undergo hepatitis C confirmation due to the high cost of HCV RNA. HCV Core Antigen might be a cost-effective diagnostic test to identify HD patients who have active HCV infection eligible for Direct Acting Anti-viral therapy. METHODS: A cross-sectional study was conducted to assess the correlation between HCV Ag and HCV RNA and the cost implications of different diagnostic algorithms to diagnose active HCV infection using Anti-HCV, HCV Ag, and HCV RNA. Pre-dialysis blood was tested for both HCV Ag and HCV RNA. HCV Ag was tested with Abbott ARCHITECT HCV Ag test. RESULTS: Two-hundred twenty-seven haemodialysis patients were recruited from 20 centres with mean age of 57.68 ± 12.48 years, and male constitutes 56.8% (129) of the study population. HCV Ag correlated well with HCV RNA (Spearman test coefficient 0.943, p < .001) with sensitivity of 93.9%, specificity 99.3%, and the accuracy was 97.36%. Cost analysis indicated that a sequential test involving Anti-HCV antibody as initial screening, followed by HCV Ag on Anti-HCV positive and HCV RNA on HCV Ag negative cases translated to a modest cost-saving algorithm compared to standard diagnostic algorithm. CONCLUSION: HCV Ag correlated well with HCV RNA and can potentially be fused in an alternative diagnostic algorithm to generate cost savings methods to diagnose active HCV infection among haemodialysis patients. This alternative algorithm is especially relevant in low to middle-income countries such as Malaysia to optimize the use of the healthcare resource and gains in clinical outcomes.

[A nationwide survey of acute pancreatitis:a report from 126 hospitals in China].

Objective: To investigate the current status of acute pancreatitis(AP) diagnosis and treatment in hospitals of different levels in China. Methods: A cross-sectional survey was conducted. The Acute Pancreatitis Diagnosis and Treatment Practice Questionnaire was designed and sent to the members of the Group of Pancreatic Surgery Chinese Society of Chinese Medical Association Branch and some other hospitals online from 8th to 24th December, 2020. Observation indicators included general information, AP diagnosis and assessment, treatment strategies, follow-up information, and comparisons of clinical practice between 3A-level and non-3A-level hospitals were performed. Counting data was used χ 2 test or Fisher exact test. Results: A total of 126 valid questionnaires were collected in final analysis, of which 75.4% (95/126) were from 3A-level hospitals, 15.9%(20/126) and 8.7%(11/126)were from other third-level and second-level hospitals,respectively. Of all participants, 88.1% (111/126)used classic AP diagnostic criteria, and 88.1% (111/126)conducted severity assessment. The revised Atlanta classification and determinant-based classification were commonly used, accounting for 72.1%(80/111) and 22.5%(25/111), respectively. 70.6%(89/126)used predictive models, including APACHE Ⅱ score, imaging models(modified CT severity index or Balthazar scoring) and Ranson criteria. For patients with early pancreatic or peripancreatic infection, 75.4%(95/126) preferred antibiotic therapy, and for those with infected walled-off necrosis, 61.1% (77/126) preferred percutaneous catheter drainage.When surgical intervention required,preferred methods were laparoscopic transabdominal surgery(37.3%, 47/126) and open surgery(25.4%,32/126). 61.1%(77/126) accepted "delayed surgery" notion. 32.5%(41/126) routinely used the step-up approach. For mild biliary acute pancreatitis, 44.4%(56/126) underwent cholecystectomy during the same hospital admission. Regarding follow-up, ideal overall follow-up periods were 6 months(46.0%,57/124) and 12 months(33.1%, 41/124), and follow-up interval was 3 months(50.8%,63/124) and 1 month(23.4%, 29/124). Comparing clinical practice of AP between 3A-level hospitals and non-3A-level hospitals, we found that the former had a significantly higher proportion of annual AP admission number of over 100(34.7%(33/95) vs.12.9%(4/31), χ 2=5.372, P=0.020), and higher proportion of routine severity assessment(68.4%(65/95) vs. 35.5%(11/31), χ²=11.107, P=0.004), higher proportion of routine severity prediction(45.3%(43/95) vs. 12.9%(4/31), χ²=13.549, P=0.001). When surgical intervention required, the proportion of step-up approach was significantly higher(37.9%(36/95) vs.16.1%(5/31), χ 2=8.512, P=0.017). Significantly more participants preferred that follow-up should be completed by full-time staff(35.8%(34/95) vs. 22.6%(7/31), χ²=8.154, P=0.043) in 3-A level hospitals. Conclusions: The standardization of AP diagnosis is relatively high in China. However, standardized assessment of severity and prediction need to be further prompted, especially in non-3A-level hospitals. Regarding AP treatment, especially the minimally invasive intervention strategy would be the focus of the promotion of standardized AP practice in the future.

[Evaluation of the reproducibility of non-verbal facial expressions in normal persons using dynamic stereophotogrammetric system].

OBJECTIVE: To assess the reproducibility of non-verbal facial expressions (smile lips closed, smile lips open, lip purse, cheek puff) in normal persons using dynamic three-dimensional (3D) imaging and provide reference data for future research. METHODS: In this study, 15 adults (7 males and 8 females) without facial asymmetry and facial nerve dysfunction were recruited. Each participant was seated upright in front of the 3D imaging system in natural head position. The whole face could be captured in all six cameras. The dynamic 3D system captured 60 3D images per second. Four facial expressions were included: smile lips closed, smile lips open, lip purse, and cheek puff. Before starting, we instructed the subjects to make facial expressions to develop muscle memory. During recording, each facial expression took about 3 to 4 seconds. At least 1 week later, the procedure was repeated. The rest position (T0) was considered as the base frame. The first quartile of expressions (T1), just after reaching the maximum state of expressions (T2), just before the end of maximum state of expressions (T3), the third quartile of expressions (T4), and the end of motion (T5) were selected as key frames. Using the stable part of face such as forehead, each key frame (T1-T5) of the different expressions was aligned on the corresponding frame at rest (T0). The root mean square (RMS) between each key frame and its corresponding frame at rest were calculated. The Wilcoxon signed ranks test was applied to assess statistical differences between the corresponding frames of the different facial expressions. RESULTS: Facial expressions like smile lips closed, smile lips open, and cheek puff were reproducible. Lip purse was not reproducible. The statistically significant differences were found on the T2 frame of the repeated lip purse movement. CONCLUSION: The dynamic 3D imaging can be used to evaluate the reproducibility of facial expressions. Compared with the qualitative analysis and two-dimensions analysis, dynamic 3D images can be able to more truly represent the facial expressions which make the research more reliable.

The effect of coordination of alkanes, Xe and CO2 (η1-OCO) on changes in spin state and reactivity in organometallic chemistry: a combined experimental and theoretical study of the photochemistry of CpMn(CO)3.

A combined experimental and theoretical study is presented of several ligand addition reactions of the triplet fragment 3CpMn(CO)2 formed upon photolysis of CpMn(CO)3. Experimental data are provided for reactions in n-heptane and perfluoromethylcyclohexane (PFMCH), as well as in PFMCH doped with C2H6, Xe and CO2. In PFMCH we find that the conversion of 3CpMn(CO)2 to 1CpMn(CO)2(PFMCH) is much slower (τ = 18 (±3) ns) than the corresponding reactions in conventional alkanes (τ = 111 (±10) ps). We measure the effect of the coordination ability by doping PFMCH with alkane, Xe and CO2; these doped ligands form the corresponding singlet adducts with significantly variable formation rates. The reactivity as measured by the addition timescale follows the order 1CpMn(CO)2(C5H10) (τ = 270 (±10) ps) > 1CpMn(CO)2Xe (τ = 3.9 (±0.4) ns) ∼ 1CpMn(CO)2(CO2) (τ = 4.7 (±0.5) ns) > 1CpMn(CO)2(C7F14) (τ = 18 (±3) ns). Electronic structure theory calculations of the singlet and triplet potential energy surfaces and of their intersections, together with non-adiabatic statistical rate theory, reproduce the observed rates semi-quantitatively. It is shown that triplet adducts of the ligand and 3CpMn(CO)2 play a role in the kinetics, and account for the variable timescales observed experimentally.

ROR1 is essential for proper innervation of auditory hair cells and hearing in humans and mice.

Hair cells of the inner ear, the mechanosensory receptors, convert sound waves into neural signals that are passed to the brain via the auditory nerve. Little is known about the molecular mechanisms that govern the development of hair cell-neuronal connections. We ascertained a family with autosomal recessive deafness associated with a common cavity inner ear malformation and auditory neuropathy. Via whole-exome sequencing, we identified a variant (c.2207G>C, p.R736T) in ROR1 (receptor tyrosine kinase-like orphan receptor 1), cosegregating with deafness in the family and absent in ethnicity-matched controls. ROR1 is a tyrosine kinase-like receptor localized at the plasma membrane. At the cellular level, the mutation prevents the protein from reaching the cellular membrane. In the presence of WNT5A, a known ROR1 ligand, the mutated ROR1 fails to activate NF-κB. Ror1 is expressed in the inner ear during development at embryonic and postnatal stages. We demonstrate that Ror1 mutant mice are severely deaf, with preserved otoacoustic emissions. Anatomically, mutant mice display malformed cochleae. Axons of spiral ganglion neurons show fasciculation defects. Type I neurons show impaired synapses with inner hair cells, and type II neurons display aberrant projections through the cochlear sensory epithelium. We conclude that Ror1 is crucial for spiral ganglion neurons to innervate auditory hair cells. Impairment of ROR1 function largely affects development of the inner ear and hearing in humans and mice.

Dramatic Alteration of 3ILCT Lifetimes Using Ancillary Ligands in [Re(L)(CO)3(phen-TPA)] n+ Complexes: An Integrated Spectroscopic and Theoretical Study.

The ground and excited state photophysical properties of a series of fac-[Re(L)(CO)3(α-diimine)] n+ complexes, where L = Br-, Cl-, 4-dimethylaminopyridine (dmap) and pyridine (py) have been extensively studied utilizing numerous electronic and vibrational spectroscopic techniques in conjunction with a suite of quantum chemical methods. The α-diimine ligand consists of 1,10-phenanthroline with the highly electron donating triphenylamine (TPA) appended in the 5 position. This gives rise to intraligand charge transfer (ILCT) states lying lower in energy than the conventional metal-to-ligand charge transfer (MLCT) state, the energies of which are red and blue-shifted, respectively, as the ancillary ligand, L becomes more electron withdrawing. The emitting state is 3ILCT in nature for all complexes studied, characterized through transient absorption and emission, transient resonance Raman (TR2), time-resolved infrared (TRIR) spectroscopy and TDDFT calculations. Systematic modulation of the ancillary ligand causes unanticipated variation in the 3ILCT lifetime by 2 orders of magnitude, ranging from 6.0 µs for L = Br- to 27 ns for L = py, without altering the nature of the excited state formed or the relative order of the other CT states present. Temperature dependent lifetime measurements and quantum chemical calculations provide no clear indication of close lying deactivating states, MO switching, contributions from a halide-to-ligand charge transfer (XLCT) state or dramatic changes in spin-orbit coupling. It appears that the influence of the ancillary ligand on the excited state lifetime could be explained in terms of energy gap law, in which there is a correlation between ln( knr) and Eem with a slope of -21.4 eV-1 for the 3ILCT emission.

Pure red cell aplasia with t-cell large granular lymphocytic leukemia.

Pure red cell aplasia (PRCA) develops as a result of erythroid precursors failing to reach maturity in the bone marrow, which eventually leads to anemia. Here we present a case of a 64-year-old Asian male with a medical history of colorectal adenocarcinoma who had been treated with 6 cycles of oxaliplatin and capecitabine four years ago. The patient was diagnosed with PRCA and T-cell large granular lymphocyte leukemia.

Literature Review of (Q)SAR Modelling of Nanomaterial Toxicity.

Despite the clear benefits that nanotechnology can bring to various sectors of industry, there are serious concerns about the potential health risks associated with engineered nanomaterials (ENMs), intensified by the limited understanding of what makes ENMs toxic and how to make them safe. As the use of ENMs for commercial purposes and the number of workers/end-users being exposed to these materials on a daily basis increases, the need for assessing the potential adverse effects of multifarious ENMs in a time- and cost-effective manner becomes more apparent. One strategy to alleviate the problem of testing a large number and variety of ENMs in terms of their toxicological properties is through the development of computational models that decode the relationships between the physicochemical features of ENMs and their toxicity. Such data-driven models can be used for hazard screening, early identification of potentially harmful ENMs and the toxicity-governing physicochemical properties, and accelerating the decision-making process by maximising the use of existing data. Moreover, these models can also support industrial, regulatory and public needs for designing inherently safer ENMs. This chapter is mainly concerned with the investigation of the applicability of (quantitative) structure-activity relationship ((Q)SAR) methods to modelling of ENMs' toxicity. It summarizes the key components required for successful application of data-driven toxicity prediction techniques to ENMs, the published studies in this field and the current limitations of this approach.

FAM65B is a membrane-associated protein of hair cell stereocilia required for hearing.

In a large consanguineous Turkish kindred with recessive nonsyndromic, prelingual, profound hearing loss, we identified in the gene FAM65B (MIM611410) a splice site mutation (c.102-1G>A) that perfectly cosegregates with the phenotype in the family. The mutation leads to exon skipping and deletion of 52-amino acid residues of a PX membrane localization domain. FAM65B is known to be involved in myotube formation and in regulation of cell adhesion, polarization, and migration. We show that wild-type Fam65b is expressed during embryonic and postnatal development stages in murine cochlea, and that the protein localizes to the plasma membranes of the stereocilia of inner and outer hair cells of the inner ear. The wild-type protein targets the plasma membrane, whereas the mutant protein accumulates in cytoplasmic inclusion bodies and does not reach the membrane. In zebrafish, knockdown of fam65b leads to significant reduction of numbers of saccular hair cells and neuromasts and to hearing loss. We conclude that FAM65B is a plasma membrane-associated protein of hair cell stereocilia that is essential for hearing.

[Concomitant unruptured intracranial aneurysms and ischemic cerebrovascular diseases: a surgical experience of 31 cases].

Objective: To summarize the clinic experience of preventing cerebral ischemic events during perioperative period in patients which concomitant unruptured intracranial aneurysms and ischemic cerebrovascular diseases. Methods: The clinical materials of 31 consecutive patients with concomitant unruptured intracranial aneurysms and ischemic cerebrovascular diseases from April 2010 to April 2014 were retrospectively reviewed.A total of 35 aneurysms were detected, and all of them were unruptured aneurysms.Among them, 17 cases were located on the ipsilateral side of artery stenosis or occlusion, and 18 cases were detected in the contralateral side. Minimal invasive surgical approaches such as small pterional approach and lateral sub-frontal approach were adopted.The better management of perioperative blood pressure was performed. Intraoperative electroencephalogram and somatosensory evoked potential monitoring, indocyanine green video angiography and/or microvascular Doppler ultrasonography were regularly used to guarantee the safety of the surgery. The follow-up by digital subtraction angiography or computed tomography angiography were made. Results: All of 35 aneurysms were clipped. Major infarction occurred in one patient with posterior communicating artery aneurysm concomitant with common cervical carotid artery stenosis.Large bone flap was resected and dural-matter were got enlarged to tolerate the edema period.Paralysis and aphasia accompanied at discharge.Minor infarction in posterior limb of internal capsule occurred in one patient.Twenty-nine patients were favorable with Glasgow Outcome Scale (GOS) score 5 at discharge, one patient with minor neurological defect (GOS 4), and one patient with severe neurological defect (GOS 3). The follow-up period was 6 to 40 months.Four patients were lost.The modified Rankin scale (MRS) of last follow-up were 0-1 in 25 patients, 2 in one patient and 3 in one patient.Third months after operation, 3 cases were performed carotid artery stenosis, 1 patients were performed carotid endarterectomy. Conclusion: Reinforcing the management of perioperative blood pressure, adjusting the perioperative blood coagulation function, and combine application of intraoperative monitoring technology can effectively prevent the occurrence of cerebral ischemia.