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BACKGROUND: Chlamydia psittaci pneumonia has atypical clinical manifestations and the diagnosis may be missed by traditional methods of microbiological diagnosis. METHODS: Twelve cases of Chlamydia psittaci pneumonia diagnosed by metagenomic next-generation sequencing (mNGS) in Huizhou Central People's Hospital in China between January 2020 and August 2021 were reviewed and analyzed, retrospectively, using hospital records, the clinical characteristics, treatment, and prognosis. RESULTS: Ten of the 12 cases (83%) were associated with a definite history of bird/poultry contact. Common symptoms included high fever, cough, fatigue, anorexia (12/12, 100%), dyspnea (11/12, 92%), and changes in the level of consciousness and headache (5/12, 42%). There was a marked increase in C-reactive protein and D-dimer levels, but white blood cells and neutrophils were normal or slightly increased. Nine patients (75%) had liver enzyme abnormalities, and six (50%) had cardiac insufficiency and myocardial injury. There was no correlation between the mNGS sequence number of Chlamydia psittaci and the pneumonia severity. The chest imaging manifestations were mainly large areas of consolidation, predominantly in the lower lung lobes. Monotherapies or combinations of doxycycline, moxifloxacin/levofloxacin, and azithromycin were effective for treating Chlamydia psittaci pneumonia. CONCLUSIONS: The use of mNGS increases the probability of diagnosing Chlamydia psittaci pneumonia, and good prognosis can be achieved with timely use of appropriate antibiotics.
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Chlamydophila psittaci , Pneumonia , Psitacose , Humanos , Chlamydophila psittaci/genética , Estudos Retrospectivos , Psitacose/diagnóstico , Sequenciamento de Nucleotídeos em Larga Escala , Pneumonia/diagnósticoRESUMO
Endoscopy for revealing the orifice of congenital H-type tracheoesophageal fistula (cTEF) is important for diagnostics and therapeutics. To facilitate the identification and catheterization of cTEF, we developed a new modified flexible endoscopy technique using a laryngeal mask with intermittent airflow. A retrospective case series study was conducted from April 2016 to July 2019 at a national regional children's medical center. Twelve infants with cTEF underwent this flexible endoscopy technique. The intermittent positive pressure airflow through laryngeal mask was able to reveal the orifice of cTEF easily in tracheal lumen. Under the visual flexible endoscope, cannulation with a 3-Fr ureteral catheter in fistula was successfully used in all cases. There were no immediate or delayed complications. This case series shows that the flexible endoscopy technique is a safe, easy, and technically efficient approach for diagnosis and cannulation of cTEF.
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Máscaras Laríngeas , Fístula Traqueoesofágica , Cateterismo , Criança , Endoscópios , Humanos , Lactente , Estudos Retrospectivos , Fístula Traqueoesofágica/diagnóstico , Fístula Traqueoesofágica/cirurgiaRESUMO
BACKGROUND: A vast majority of patients with NSCLC (non-small cell lung cancer) have lung adenocarcinoma (LA), and the survival rate of LA varies from 5% to 75% depending on the severity of this adenocarcinoma. PYCR1 (abnormal pyrroline-5-carboxylate reductase 1) gene and miR-328-3p have been found to be associated with cancer development. However, the underlying mechanism of interaction between miR-328-3p and PYCR1 in LA needs further investigation. METHODS: The expressions of miR-328-3p and PYCR1 in samples with LA were identified by RT-qPCR. Next, we investigated the targeting relationship between these two biological factors using luciferase assay. CCK-8, BrdU, transwell-migration, and flow cytometry assays were performed to detect cell viability, cell proliferation, cell migration and cell apoptosis in LA cells. RESULTS: We noticed that miR-328-3p expression was downregulated in LA samples. MiR-328-3p mimic restricted cell proliferation and cell migration, while it enhanced cell apoptosis. Furthermore, the overexpression of PYCR1 promoted the proliferation and migration of LA cells, but it repressed cell apoptosis. Moreover, PYCR1 directly interacted with miR-328-3p in the LA cells, and miR-328-3p restrained the expression of PYCR1, thus suppressing LA tumorigenesis. CONCLUSION: In summary, our study revealed that miR-328-3p targeting to PYCR1 suppressed the malignancy of LA cells by impeding cell proliferation and migration, while effectively promoting cell apoptosis.
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Adenocarcinoma de Pulmão/genética , Adenocarcinoma de Pulmão/prevenção & controle , Regulação para Baixo/genética , Neoplasias Pulmonares/genética , Neoplasias Pulmonares/prevenção & controle , MicroRNAs/genética , Pirrolina Carboxilato Redutases/deficiência , Pirrolina Carboxilato Redutases/genética , Adenocarcinoma de Pulmão/patologia , Apoptose/genética , Sequência de Bases , Linhagem Celular Tumoral , Movimento Celular/genética , Proliferação de Células/genética , Progressão da Doença , Humanos , Neoplasias Pulmonares/patologia , Pirrolina Carboxilato Redutases/biossíntese , delta-1-Pirrolina-5-Carboxilato RedutaseRESUMO
BACKGROUND: Immature platelet fraction (IPF) is a new biomarker for thrombopoiesis and inflammation. However, the reference interval (RI) is wildly discrepant among published reports. This study aimed to establish the RI of IPF for a population in Taiwan and evaluate the effects the detection method of the analyzer, ethnicity, and reference individuals have on the RI of IPF. METHODS: The RI of absolute IPF (A-IPF) and IPF% were established with healthy subjects from the outpatient services of the Health Management Department of Taichung Veterans General Hospital between January 1, 2015 and March 1, 2016. These values were used along with published reports for meta-analysis. RESULTS: A-IPF (109/L) and IPF% of Taiwanese were 6.9 - 7.6 and 3.1 - 3.4, respectively. Significant differences were found when performing paired comparisons of the RI of A-IPF and IPF% published in reports. For A-IPF, there was only one paired comparison with a significant difference (Z > 1.96) across 6 reports. Thus, the contribution of the factors examined on the RI of IPF cannot be determined. For IPF%, there were 8 paired comparisons with significant differences across 10 reports. The discrepancy rates of RI for IPF% were 41.2%, 50.0%, and 25.0% with the difference of reference individuals, the analyzer method, and ethnicity, respectively. CONCLUSIONS: The RIs of Taiwanese for A-IPF and IPF% were established. Furthermore, the analyzer detection method and the reference individuals contribute to the discrepancy of the RI for IPF% and should be considered cautiously when the value of IPF is interpreted.
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Biomarcadores/sangue , Plaquetas/metabolismo , Inflamação/sangue , Contagem de Plaquetas/instrumentação , Trombopoese , Adulto , Povo Asiático , Técnicas de Laboratório Clínico/instrumentação , Técnicas de Laboratório Clínico/métodos , Feminino , Humanos , Inflamação/etnologia , Masculino , Pessoa de Meia-Idade , Contagem de Plaquetas/métodos , Valores de Referência , TaiwanRESUMO
PURPOSE: Platelet-rich plasma (PRP) has been utilized in the treatment of chronic injuries. The current study aimed to evaluate the efficiency of PRP in the treatment of frozen shoulder compared to procaine. MATERIALS AND METHODS: 60 patients with frozen shoulder were randomly divided into two groups. The PRP group was injected with 2 mL prepared PRP, while in the control group procaine was used. The stretching and formal strengthening exercises were carried out in both groups during the 6-month follow-up. Visual analog scale (VAS) score was used to assess the subjective pain intensity of the patients. The general shoulder assessment instruments (University of California at Los Angeles (UCLA) shoulder scale) was applied to measure the shoulder function of the patients. The evaluation was performed before treatment and 1 week, 1 month, 3 months, and 6 months after the first injection. RESULTS: The efficiency of PRP was superior to and longer than procaine. VAS scores were both declined in PRP and control group after 1 week, 1 month, and 3 months of first injection. By contrast, it was elevated was elevated in the control group while continued to decline in PRP group. The UCLA scores were almost linearly improved in the PRP group, while the UCLA scores decreased to a lower level at the final follow-up visit compared to that post 3 months in the control group. CONCLUSION: PRP and procaine were effective in treating frozen shoulder. PRP was more effective and had a more prolonged efficiency than the procaine control. Nevertheless, the definite conclusion should come from further large-scale clinical trials.â©.
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Bursite/terapia , Plasma Rico em Plaquetas , Idoso , Anestésicos Locais/uso terapêutico , Bursite/fisiopatologia , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Medição da Dor , Procaína/uso terapêutico , Ombro/fisiopatologia , Resultado do TratamentoRESUMO
Fingerprinting-based indoor localization suffers from its time-consuming and labor-intensive site survey. As a promising solution, sample crowdsourcing has been recently promoted to exploit casually collected samples for building offline fingerprint database. However, crowdsourced samples may be annotated with erroneous locations, which raises a serious question about whether they are reliable for database construction. In this paper, we propose a cross-domain cluster intersection algorithm to weight each sample reliability. We then select those samples with higher weight to construct radio propagation surfaces by fitting polynomial functions. Furthermore, we employ an entropy-like measure to weight constructed surfaces for quantifying their different subarea consistencies and location discriminations in online positioning. Field measurements and experiments show that the proposed scheme can achieve high localization accuracy by well dealing with the sample annotation error and nonuniform density challenges.
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BACKGROUND: Micro-RNAs (miRNAs) play important roles in the regulation of immune response and inflammation. The purpose of this study was to investigate the association between three single nucleotide polymorphisms (SNPs) (mir-146a rs2910164, let-7a-2 rs1143770, miR-196a2 rs11614913) and susceptibility to and severity of childhood immunoglobulin A (IgA) nephropathy (IgAN). METHODS: We genotyped three miRNA SNPs in two independent Han Chinese populations composed of 158 patients and 265 controls (discovery set), and 246 patients and 446 controls (validation set), respectively. RESULTS: We found that rs2910164 was significantly associated with IgAN in the discovery but not the validation set. Combined analysis revealed that rs2910164 CC and CG genotypes were associated with increased risk of IgAN compared with the GG genotype [adjusted odds ratios (OR) = 1.684, 95 % confidence interval (CI)1.190-2.384, P = 0.003; adjusted OR = 1.472, 95 % CI 1.079-2.007, P = 0.015, respectively). We also found that the frequency of the rs2910164 CC genotype was significantly higher in patients with Haas grade III-V than in those with Haas grade I-II for all study populations (P < 0.05). The expression of miR-146a in normal renal tissues with CC genotype was lower than in those with a G allele (P = 0.038). CONCLUSIONS: These results indicated that rs2910164 may affect the susceptibility and severity of pediatric IgAN. Further studies are needed to validate these findings.
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Predisposição Genética para Doença/genética , Glomerulonefrite por IGA/genética , MicroRNAs/genética , Povo Asiático/genética , Estudos de Casos e Controles , Criança , Feminino , Genótipo , Humanos , Masculino , Polimorfismo de Nucleotídeo Único , Reação em Cadeia da Polimerase em Tempo RealRESUMO
Background and Objective: Bronchoscopy is a widely used diagnostic and therapeutic procedure for respiratory disorders such as infections and tumors. However, visualizing the bronchial tubes and lungs can be challenging due to the presence of various objects, such as mucus, blood, and foreign bodies. Accurately identifying the anatomical location of the bronchi can be quite challenging, especially for medical professionals who are new to the field. Deep learning-based object detection algorithms can assist doctors in analyzing images or videos of the bronchial tubes to identify key features such as the epiglottis, vocal cord, and right basal bronchus. This study aims to improve the accuracy of object detection in bronchoscopy images by integrating a YOLO-based algorithm with a CBAM attention mechanism. Methods: The CBAM attention module is implemented in the YOLO-V7 and YOLO-V8 object detection models to improve their object identification and classification capabilities in bronchoscopy images. Various YOLO-based object detection algorithms, such as YOLO-V5, YOLO-V7, and YOLO-V8 are compared on this dataset. Experiments are conducted to evaluate the performance of the proposed method and different algorithms. Results: The proposed method significantly improves the accuracy and reliability of object detection for bronchoscopy images. This approach demonstrates the potential benefits of incorporating an attention mechanism in medical imaging and the benefits of utilizing object detection algorithms in bronchoscopy. In the experiments, the YOLO-V8-based model achieved a mean Average Precision (mAP) of 87.09% on the given dataset with an Intersection over Union (IoU) threshold of 0.5. After incorporating the Convolutional Block Attention Module (CBAM) into the YOLO-V8 architecture, the proposed method achieved a significantly enhanced m A P 0.5 and m A P 0.5 : 0.95 of 88.27% and 55.39%, respectively. Conclusions: Our findings indicate that by incorporating a CBAM attention mechanism with a YOLO-based algorithm, there is a noticeable improvement in object detection performance in bronchoscopy images. This study provides valuable insights into enhancing the performance of attention mechanisms for object detection in medical imaging.
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Immunomodulatory effects of long-chain fatty acids (LCFAs) and their activating enzyme, acyl-coenzyme A (CoA) synthetase long-chain family (ACSL), in the tumor microenvironment remain largely unknown. Here, we find that ACSL5 functions as an immune-dependent tumor suppressor. ACSL5 expression sensitizes tumors to PD-1 blockade therapy in vivo and the cytotoxicity mediated by CD8+ T cells in vitro via regulation of major histocompatibility complex class I (MHC-I)-mediated antigen presentation. Through screening potential substrates for ACSL5, we further identify that elaidic acid (EA), a trans LCFA that has long been considered harmful to human health, phenocopies to enhance MHC-I expression. EA supplementation can suppress tumor growth and sensitize PD-1 blockade therapy. Clinically, ACSL5 expression is positively associated with improved survival in patients with lung cancer, and plasma EA level is also predictive for immunotherapy efficiency. Our findings provide a foundation for enhancing immunotherapy through either targeting ACSL5 or metabolic reprogramming of antigen presentation via dietary EA supplementation.
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Apresentação de Antígeno , Neoplasias , Ácidos Oleicos , Humanos , Linfócitos T CD8-Positivos/metabolismo , Receptor de Morte Celular Programada 1 , Suplementos Nutricionais , Microambiente Tumoral , Coenzima A Ligases/metabolismoRESUMO
Purpose: A micrometer scale hyporeflective band within the retinal pigment epithelium basal lamina - Bruch's membrane complex (RPE-BL-BrM) was topographically measured in aging and age-related macular degeneration (AMD). Methods: In a prospective cross-sectional study, 90 normal eyes from 76 subjects (range = 23-90 years) and 53 dry AMD eyes from 47 subjects (range = 62-91 years) were enrolled. Isotropic volume raster scans over 6 mm × 6 mm (500 × 500 A-scans) were acquired using a high-resolution (2.7 µm axial resolution) spectral-domain optical coherence tomography (SD-OCT) prototype instrument. Six consecutive optical coherence tomography (OCT) volumes were computationally motion-corrected and fused to improve feature visibility. A boundary regression neural network was developed to measure hyporeflective band thickness. Topographic dependence was evaluated over a 6-mm-diameter Early Treatment Diabetic Retinopathy Study (ETDRS) grid. Results: The hyporeflective band thickness map (median of 4.3 µm and 7.8 µm in normal and AMD eyes, respectively) is thicker below and radially symmetric around the fovea. In normal eyes, age-associated differences occur within 0.7 to 2.3 mm from the foveal center (P < 0.05). In AMD eyes, the hyporeflective band is hypothesized to be basal laminar deposits (BLamDs) and is thicker within the 3-mm ETDRS circle (P < 0.0002) compared with normal eyes. The inner ring is the most sensitive location to detect age versus AMD-associated changes within the RPE-BL-BrM. AMD eyes with subretinal drusenoid deposits (SDDs) have a significantly thicker hyporeflective band (P < 0.001) than those without SDDs. Conclusions: The hyporeflective band is a quantifiable biomarker which differentiates AMD from aging. Longitudinal studies are warranted. The hyporeflective band may be a useful biomarker for risk stratification and disease progression.
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Envelhecimento , Epitélio Pigmentado da Retina , Tomografia de Coerência Óptica , Humanos , Tomografia de Coerência Óptica/métodos , Epitélio Pigmentado da Retina/patologia , Epitélio Pigmentado da Retina/diagnóstico por imagem , Idoso , Pessoa de Meia-Idade , Estudos Prospectivos , Estudos Transversais , Feminino , Masculino , Idoso de 80 Anos ou mais , Envelhecimento/fisiologia , Adulto , Adulto Jovem , Lâmina Basilar da Corioide/patologia , Lâmina Basilar da Corioide/diagnóstico por imagem , Degeneração Macular/diagnóstico , Degeneração Macular/fisiopatologiaRESUMO
BACKGROUND: To clarify the molecular mechanisms that participate in the severe hand, foot and mouth disease (HFMD) infected by Enterovirus 71 and to detect any related protein biomarkers, we performed proteomic analysis of protein extracts from 5 extremely severe HFMD children and 5 healthy children. METHODS: The protein profiles of them were compared using two-dimensional electrophoresis. Differentially expressed proteins were identified using mass spectrometry. Functional classifications of these proteins were based on the PANTHER. The interaction network of the differentially expressed protein was generated with Pathway Studio. RESULTS: A total of 38 differentially expressed proteins were identified. Functional classifications of these proteins indicated a series of altered cellular processes as a consequence of the severe HFMD. These results provided not only new insights into the pathogenesis of severe HFMD, but also implications of potential therapeutic designs. CONCLUSIONS: Our results suggested the possible pathways that could be the potential targets for novel therapy: viral protection, complement system and peroxide elimination.
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Enterovirus Humano A/isolamento & purificação , Doença de Mão, Pé e Boca/sangue , Proteoma/análise , Proteínas Sanguíneas/análise , Western Blotting , Eletroforese em Gel Bidimensional , Humanos , Mapas de Interação de Proteínas , Proteômica , Reprodutibilidade dos Testes , Espectrometria de Massas por Ionização e Dessorção a Laser Assistida por MatrizRESUMO
In this paper, analytic modeling for the design of a transient thermal invisibility cloak with imperfect interfaces is presented together with numerical simulations. In contrast to steady-state conditions, it is shown that an object can only be made partially invisible under a transient-state condition with either ideal or imperfect interfaces. The thermal visibility of an object to the external region can be optimally suppressed under certain conditions referred to as the "weak invisibility conditions" for the transient response, which are different from the "strong invisibility conditions" that can completely conceal an object in a steady state. In the formulation, a homogeneous metamaterial with constant volumetric heat capacity and constant anisotropic conductivity tensor is employed. It can be demonstrated that the interface's bonding conditions will have a significant effect on the design of metamaterials. Two typical types of imperfect interfaces, referred to as low-conductivity- and high-conductivity-type interfaces, are considered. Conditions, that render an object mostly undetectable, are analytically found and expressed in simple forms under quasi-static approximations. Within the quasi-static limit, the thermal localization in the target region can be tuned with the anisotropy of the conductivity tensor. Thermal shielding or concentrating effects in the target region are exemplified based on finite element simulations to demonstrate the manipulation of heat flux in the target region. The present findings make new advances in theoretical fundamentals and numerical simulations on the effect of the imperfect interface in the transient regime and can serve as guidelines in the design of thermal metamaterials through the entire conduction process.
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OBJECTIVE: To explore clinical efficacy of dorsal plate assisted fixation of dorsal lunate fossa fracture block of distal radius. METHODS: From January 2019 to January 2022, 30 patients were treated with dorsal plate assisted fixation of dorsal lunate fossa fracture of distal radius, including 13 males and 17 females, aged from 42 to 68 years old with an average of (48.7±5.6) years old;According to Doi fracture classification, 24 patients were type 3 blocks and 6 patients were type 4 blocks. The degree of palmar angle of anterior and posterior distal radius was fixed by dorsal steel plate during operation. Fracture healing and functional recovery of wrist were observed after operation. Functional evaluation was performed by Gartland and Werley scoring system at 12 months after operation. RESULTS: All patients were followed up from 12 to 13 months with an average of (11.3±0.9) months. All fractures healed for 4 to 5 months with an average of(4.7±0.8) months. Median palpal inclination of anterior and posterior distal radius fixed by dorsal plate was 5.30°(4.85°, 6.03°), 12.45°(11.98°, 13.43°) respectively, and had statistical difference( P<0.01). Gartland and Werley scores was (1.1±0.4) at 12 months afteropertaion, and 27 patients got excellent result and 3 good. CONCLUSION: Dorsal plate assisted fixation of dorsal lunate fossa fractures is beneficial to reduction and stabilization of displaced dorsal fractures and restoration of palmar inclination.
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Fraturas Ósseas , Osso Semilunar , Feminino , Masculino , Humanos , Adulto , Pessoa de Meia-Idade , Idoso , Rádio (Anatomia)/cirurgia , Osso Semilunar/cirurgia , Extremidade Superior , Articulação do Punho , PunhoRESUMO
Purpose: Ultrahigh resolution spectral domain-OCT (UHR SD-OCT) enables in vivo visualization of micrometric structural markers which differentially associate with normal aging versus age-related macular degeneration (AMD). This study explores the hypothesis that UHR SD-OCT can detect and quantify sub-retinal pigment epithelium (RPE) deposits in early AMD, separating AMD pathology from normal aging. Design: Prospective cross-sectional study. Participants: A total of 53 nonexudative (dry) AMD eyes from 39 patients, and 63 normal eyes from 39 subjects. Methods: Clinical UHR SD-OCT scans were performed using a high-density protocol. Exemplary high-resolution histology and transmission electron microscopy images were obtained from archive donor eyes. Three trained readers evaluated and labeled outer retina morphological features, including the appearance of a hyporeflective split within the RPE-RPE basal lamina (RPE-BL)-Bruch's membrane (BrM) complex on UHR brightness (B)-scans. A semi-automatic segmentation algorithm measured the thickness of the RPE-BL-BrM split/hyporeflective band. Main Outcome Measures: Qualitative description of outer retinal morphological changes on UHR SD-OCT B-scans; the proportion of the RPE-BL-BrM complex with visible split (%) and the thickness of the resulting hyporeflective band (µm). Results: In young normal eyes, UHR SD-OCT consistently revealed an RPE-BL-BrM split/hyporeflective band. Its visibility and thickness were less in eyes of advanced age. However, the split/hyporeflective band was again visible in early AMD eyes. Both qualitative reading and quantitative thickness measurements showed significantly elevated visibility and thickness of the RPE-BL-BrM split/hyporeflective in early AMD eyes compared to age-matched controls. Conclusions: Our imaging results strongly support the hypothesis that appearance of the RPE-BL-BrM split/hyporeflective band in older subjects is dominated by the BL deposit, an indicator of early AMD well known from histology. Ultrahigh resolution SD-OCT can be used to investigate physiological aging as well as early AMD pathology in clinical imaging studies. Developing quantifiable markers associated with disease pathogenesis and progression can facilitate drug discovery, as well as reduce clinical trial times. Financial Disclosures: Proprietary or commercial disclosure may be found after the references.
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Thermal metamaterials are of great importance in advanced energy control and management. Previous studies mainly focused on interfaces with perfect bonding conditions. In principle, imperfectness always exists across interface and the effect is intriguingly important with small-length scales. This work reports the imperfect interface effect in thermal metamaterials thoroughly. Low conductivity- and high conductivity-type interfaces are considered. We show that an object can always be made thermally invisible, with the effect of imperfect interface, as that of a homogeneous background material. This unprecedented condition is derived in an exact and analytic form, systematically structured, with much versatile and physical implications. Conditions for thermal shielding and enhancements are analytically found and numerically exemplified, highlighting the specific role of material and geometric parameters. We find that both types of interfaces are complementing with each other which, all together, will constitute a full spectrum to achieve the thermal invisibility. The analytic finding offers a general perception that adds to the understanding of heat transport mechanism across interfaces in thermal metamaterials, in ways that drastically distinct from that of ideal interfaces. This finding opens up new possibilities for the control and management of thermal metamaterials with imperfect bonding interfaces.
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Psittacosis and Guillain-Barré syndrome are both rare clinical diseases with low incidence, and their combination has rarely been reported. Here, we report a case of Chlamydia psittaci pneumonia combined with Guillain-Barré syndrome. The patient initially presented with high fever, difficulty breathing, and fatigue. Chest computerised tomography indicated large consolidation opacities in both lungs. Metagenomic next-generation sequencing clearly identified the pathogen as C. psittaci. The patient's fever subsided after targeted antibiotic treatment, but difficulty breathing and fatigue worsened, and the patient developed symmetric limb numbness and weakness. Lumbar puncture, electrophysiological examination, and clinical characteristics were suggestive of Guillain-Barré syndrome, and the symptoms improved after treatment with human immunoglobulin. The results of this study suggest that metagenomic next-generation sequencing is useful for the rapid diagnosis of pulmonary infectious agents. Psittacosis is closely associated with the development of Guillain-Barré syndrome; however, more cases are needed to support this conclusion, and early targeted antibiotic treatment, immunotherapy, and basic supportive treatment are essential for improving outcomes.
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Chlamydophila psittaci , Síndrome de Guillain-Barré , Pneumonia , Psitacose , Humanos , Síndrome de Guillain-Barré/complicações , Síndrome de Guillain-Barré/diagnóstico , Chlamydophila psittaci/genética , Psitacose/complicações , Psitacose/diagnóstico , Antibacterianos/uso terapêutico , Pneumonia/complicações , Fadiga/complicações , Sequenciamento de Nucleotídeos em Larga EscalaRESUMO
Psittacosis is a rare zoonotic disease caused by Chlamydia psittaci infection, and tetracyclines are the preferred treatment. Omadacycline is a novel tetracycline that has a strong in vitro antibacterial activity against atypical pathogens, including C. psittaci; however, clinical data for its usage are lacking. We report a patient with severe C. psittaci-induced pneumonia presenting with a high fever, muscle aches, severe hepatic and renal insufficiency, and acute respiratory failure requiring tracheal intubation and mechanical ventilation. The condition was diagnosed using metagenomic next-generation sequencing. The patient was discharged after treatment with omadacycline. The findings of this study suggest that metagenomic next-generation sequencing is valuable for the rapid and accurate diagnosis of psittacosis. With its good safety profile and no requirement for dose adjustment in special populations, omadacycline is a new option for the treatment of severe C. psittaci pneumonia. However, additional case reports are needed to support this conclusion.
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Background: The impact of miR-145-5p in immune infiltration and the potential application in esophageal squamous cell carcinoma (ESCC) immunochemotherapy remains unknown. Methods: Transcriptomic data for ESCC tissues and normal tissues and clinical materials of patients with ESCC were obtained from The Cancer Genome Atlas (TCGA) and the Gene Expression Omnibus (GEO) databases. The differences in mRNA levels in cancer tissues and noncancerous tissues were analyzed, and we subsequently investigated the association between miR-145-5p expression and the key parameters of ESCC progression and prognosis. Additionally, cytological experiments were performed to evaluate the biological functions of miR-145-5p. Pathways potentially affected by miR-145-5p were analyzed by Gene Set Enrichment Analysis (GSEA) and REACTOME. We also analyzed the function of miR-145-5p in immune infiltration through the TIMER2 (Tumor Immune Estimation Resource) database. Results: The analysis of gene chip data from the TCGA database and GEO database (including GSE13937 and GSE43732) showed that the expression of miR-145-5p is downregulated in ESCC (P<0.05) and that patients with high miR-145-5p levels had lower survival rates (P<0.05). The expression of miR-145-5p was significantly correlated with the disease-free survival (DFS) rate (P<0.05) and M stage (P<0.05) in the TCGA database and was significantly correlated with the T stage (P<0.05) and TNM stage (P<0.05) in the GSE13937 database. Functional experiments showed that miR-145-5p attenuated proliferation (P<0.05), migration (P<0.01) and invasion (P<0.01) in the Eca109 cell line. Both GSEA gene enrichment and REACTOME gene enrichment revealed that miR-145-5p was associated with tumor signaling pathways and immune signaling pathways. Immune infiltration analysis revealed that the expression level of miR-145-5p was significantly correlated with the infiltration level of macrophages (P<0.05) and was positively correlated with the level of gene markers of M2 macrophages and tumor-associated macrophages (P<0.05). Conclusions: MiR-145-5p acts as a tumor suppressor microRNA in ESCC and is an important noncoding RNA in the high M2-like tumor-associated macrophage infiltration of ESCC. Assessing the miR-145-5p level in ESCC samples has translational meaning, which help illustrate the immune infiltration status, predict the prognostic outcome, and select the type of immunochemotherapy.
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This study reports the development of prototype swept-source optical coherence tomography (SS-OCT) technology for imaging the anterior eye. Advances in vertical-cavity surface-emitting laser (VCSEL) light sources, signal processing, optics and mechanical designs, enable a unique combination of high speed, long range, and deep penetration that addresses the challenges of anterior eye imaging. We demonstrate SS-OCT with a 325 kHz A-scan rate, 12.2 µm axial resolution (in air), and 15.5 mm depth range (in air) at 1310 nm wavelength. The ultrahigh 325 kHz A-scan rate not only facilitates biometry measurements by minimizing acquisition time and thus reducing motion, but also enables volumetric OCT for comprehensive structural analysis and OCT angiography (OCTA) for visualizing vasculature. The 15.5 mm (~ 11.6 mm in tissue) depth range spans all optical surfaces from the anterior cornea to the posterior lens capsule. The 1310 nm wavelength range enables structural OCT and OCTA deep in the sclera and through the iris. Achieving high speed and long range requires linearizing the VCSEL wavenumber sweep to efficiently utilize analog-to-digital conversion bandwidth. Dual channel recording of the OCT and calibration interferometer fringe signals, as well as sweep to sweep wavenumber compensation, is used to achieve invariant 12.2 µm (~ 9.1 µm in tissue) axial resolution and optimum point spread function throughout the depth range. Dynamic focusing using a tunable liquid lens extends the effective depth of field while preserving the lateral resolution. Improved optical and mechanical design, including parallax "split view" iris cameras and stable, ergonomic patient interface, facilitates accurate instrument positioning, reduces patient motion, and leads to improved imaging data yield and measurement accuracy. We present structural and angiographic OCT images of the anterior eye, demonstrating the unique imaging capabilities using representative scanning protocols which may be relevant to future research and clinical applications.
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Segmento Anterior do Olho/diagnóstico por imagem , Tomografia de Coerência Óptica/métodos , Angiografia/métodos , Segmento Anterior do Olho/irrigação sanguínea , Biometria/métodos , Humanos , Tomografia de Coerência Óptica/instrumentaçãoRESUMO
Radiology report generation through chest radiography interpretation is a time-consuming task that involves the interpretation of images by expert radiologists. It is common for fatigue-induced diagnostic error to occur, and especially difficult in areas of the world where radiologists are not available or lack diagnostic expertise. In this research, we proposed a multi-objective deep learning model called CT2Rep (Computed Tomography to Report) for generating lung radiology reports by extracting semantic features from lung CT scans. A total of 458 CT scans were used in this research, from which 107 radiomics features and 6 slices of segmentation related nodule features were extracted for the input of our model. The CT2Rep can simultaneously predict position, margin, and texture, which are three important indicators of lung cancer, and achieves remarkable performance with an F1-score of 87.29%. We conducted a satisfaction survey for estimating the practicality of CT2Rep, and the results show that 95% of the reports received satisfactory ratings. The results demonstrate the great potential in this model for the production of robust and reliable quantitative lung diagnosis reports. Medical personnel can obtain important indicators simply by providing the lung CT scan to the system, which can bring about the widespread application of the proposed framework.