Sarcomatoid renal cell carcinoma: a case report and literature review.

BACKGROUND: The poorly differentiated renal cell carcinoma (RCC) with rhabdomyosarcomatous sarcomatoid differentiation shows a severely aggressive biological behavior characterized by rapid disease progression. Preoperative identification of the subtype with the prognostic factors and imaging features of sarcomatoid renal cell carcinoma (SRCC) would be of great clinical significance. CASE PRESENTATION: A 45-year-old male patient presented a nine day history of gross hematuria without any other symptoms. A computed tomography (CT) and a full-body fluorine-18 fluoro-2-deoxyglucose (FDG) positron emission tomography (PET) - computed tomography (CT) scan urogram were performed. An initial diagnosis identified a space-occupying lesion of the right kidney, retroperitoneal and right renal hulum lymph node metastases, as well as a space-occupying lesion of the third thoracic vertebra (T3). A right radical nephrectomy was performed. Pathologic analysis revealed poorly differentiated RCC with rhabdomyosarcomatous sarcomatoid differentiation that extends into the renal sinus and the ureteral (T3N1M1). Five days later, the Magnetic Resonance imaging (MRI) evidenced a diffused osseous metastatic disease in the thoracic and lumbar vertebra and multiple retroperitoneal lymph node metastases. The disease progressed quickly to multiple organ dysfunction syndrome (MODS) in half a month and the patient died of respiratory failure two days later. The patient refused any chemoradiotherapy in the hospital. CONCLUSIONS: Our case presents a SRCC with severe, aggressive, and rapid disease progression. Classifying SRCC imaging features by CT, MRI as well as PET-CT techniques could potentially be helpful for preoperative identification of the subtype. The prognostic factors of SRCC would be of great clinical interest.

[Correlation between Fractional Anisotropy and Amyotrophic Lateral Sclerosis, and Effect of Inte- grative Medical Treatment on ALS].

OBJECTIVE: To explore whether fractional anisotropy (FA) value could be taken as a quantitative indicator for tracing and reexamining amyotrophic lateral sclerosis (ALS), and to analyze the correlation between FA value and integrative medical treatment. METHODS: Totally 18 ALS patients were recruited in this study. All patients received diffusion tensor imaging (DTI) using 3. OT (Propeller HD) MRI twice. Six regions of interest (ROI) were selected to measure FA values. Survival analyses were performed in 11 cases of end point events. RESULTS: (1) Three ROI (cerebral peduncle, posterior limb of internal capsule, and corona radiata) all indicated that FA value was the highest in patients with mild health status scale of amyotrophic lateral sclerosis (ALS/HSS). (2) There was statistical difference in the means of FA values in cerebral peduncle, posterior limb of internal capsule, and corona radiata of 18 cases between initial examination and reexamination (P < 0.01). (3) Kaplan-Meier survival curve showed the survival rate of ALS patients decreased as time went by, with the median survival time of 48 months. CONCLUSIONS: FA value was inversely proportional to the severity of ALS, the more severe, the lower FA values. FA value was an objective indicator for assessing the severity of ALS. ALS is an incurable disease till now. Integrative medical treatment might become one direction for ALS patients.

Influence of Green Finance on Ecological Environment Quality in Yangtze River Delta.

Along with the development of society and the deepening contradiction between economic growth and natural resources, green finance has attracted more and more attention. As an area of great strategic significance in China's modernization, the development of green finance can improve the quality of its ecological environment and find new economic growth points for it. Based on the index system of pressure state response and while considering the scientific nature and desirability of the indicators, this paper selects 12 indicators to construct an index system of eco-environmental quality. It uses the entropy method to calculate the level of eco-environmental quality. Then, three control variables are selected, and the difference-in-difference model is used for empirical analysis. It is found that green finance positively affects the ecological environment quality of the Yangtze River Delta. In addition, the level of opening to the outside world and the level of economic development also have a positive effect on the quality of the ecological environment to a certain extent. Still, the impact of industrial structure on it is negative. Therefore, this paper puts forward some suggestions for strengthening the disclosure of green financial information, paying attention to the concept of green development and strengthening regional cooperation and exchange to promote the development of green finance further and promote the coordination of economic development and ecological protection in the Yangtze River Delta.

Parallel label propagation algorithm based on weight and random walk.

Community detection is a complex and meaningful process, which plays an important role in studying the characteristics of complex networks. In recent years, the discovery and analysis of community structures in complex networks has attracted the attention of many scholars, and many community discovery algorithms have been proposed. Many existing algorithms are only suitable for small-scale data, not for large-scale data, so it is necessary to establish a stable and efficient label propagation algorithm to deal with massive data and complex social networks. In this paper, we propose a novel label propagation algorithm, called WRWPLPA (Parallel Label Propagation Algorithm based on Weight and Random Walk). WRWPLPA proposes a new similarity calculation method combining weights and random walks. It uses weights and similarities to update labels in the process of label propagation, improving the accuracy and stability of community detection. First, weight is calculated by combining the neighborhood index and the position index, and the weight is used to distinguish the importance of the nodes in the network. Then, use random walk strategy to describe the similarity between nodes, and the label of nodes are updated by combining the weight and similarity. Finally, parallel propagation is comprehensively proposed to utilize label probability efficiently. Experiment results on artificial network datasets and real network datasets show that our algorithm has improved accuracy and stability compared with other label propagation algorithms.

Relationship of ankle-brachial index, vibration perception threshold, and current perception threshold to glycemic variability in type 2 diabetes.

To explore the relationship of glycemic variability with lower extremity arterial disease (LEAD) and diabetic peripheral neuropathy (DPN).Seventy-eight patients with type 2 diabetes were enrolled. All patients underwent 72-hour dynamic blood glucose monitoring and obtained mean amplitude of glycemic excursions (MAGE), mean of daily differences (MODD), standard deviation of blood glucose (SD), largest amplitude of glycemic excursion (LAGE), mean blood glucose (MBG), T≥10.0 (percentage of time for blood glucose levels ≥10.0 mmol/L), T≤3.9 (percentage of time for blood glucose levels ≤3.9 mmol/L), and other glycemic variability parameters. In the meanwhile, in order to explore the correlation of glycemic variability parameters with ankle-brachial index (ABI), vibration perception threshold (VPT), and current perception threshold (CPT), all patients underwent quantitative diabetic foot screening, including ABI for quantitative assessment of lower extremity arterial lesions and VPT and CPT for quantitative assessment of peripheral neuropathy.Patients were divided into abnormal CPT group (n = 21) and normal CPT group (n = 57) according to the CPT values. Compared with the normal CPT group, abnormal CPT group showed significantly higher levels of HbA1c, longer duration of diabetes, and higher levels of T≤3.9 (P < .05). However, there was no significant difference of MAGE, SD, LAGE, MODD, and other glycemic variability parameters between abnormal CPT group and normal CPT group (P > .05). Pearson correlation analysis or Spearman correlation analysis showed that ABI negatively correlated with MBG, T≥10.0, SD, LAGE, and MAGE (P < .05), but no correlation of ABI with T≤3.9 and MODD (P > .05) was shown. VPT showed a positive correlation with T≥10.0 (P < .05), but no correlation with other glycemic variability parameters (P > .05). There was no correlation between the other CPT values and the glycemic variability parameters (P > .05), except that the left and right 250 Hz CPT values were positively correlated with T≤3.9 (P > .05).The higher the blood glucose levels, the severer the degree of LEAD and DPN lesions; the higher the incidence of hypoglycemia, the severer the degree of DPN lesions; the greater the fluctuation of blood glucose, the severer the degree of LEAD lesions. However, the glycemic variability was not significantly correlated with DPN.

Quantitative assessment of amyotrophic lateral sclerosis with diffusion tensor imaging in 3.0T magnetic resonance.

Diffusion tensor imaging (DTI) was used to measure the fractional anisotropy (FA) and apparent diffusion coefficient (ADC) value in amyotrophic lateral sclerosis (ALS) patients to determine their diagnostic value. 69 ALS patients and 23 healthy controls were scanned with DTI sequence in 3.0T MR, and FA and ADC values in 18 regions were evaluated. Compared with the controls, the ADC values of patients in bilateral centrum semiovale, deep frontal and parietal white matter were significantly increased (P < 0.05), while the FA values in cerebral peduncle, posterior limb of internal capsule (PLIC), corona radiata, centrumsemiovale, bilateral deep frontal white matter, the genu and the splenium of the corpus callosum were significantly decreased (P < 0.05). When the FA cut-off value was set to ≤ 0.6860 for the cerebral peduncle, sensitivity (SE) and specificity (SP) of ALS were 95.7% and 83.9% respectively. When the cut-off value was set to ≤ 0.7085 for PLIC, SE and SP were 95.7% and 85.7% respectively. When the cut-off value was set to ≤ 0.6950 for corona radiata, SE and SP were 100.0% and 95.7%, respectively. DTI can be used to quantitatively evaluate injury in ALS patients.