ABSTRACT
Esophageal spindle-cell squamous cell carcinoma (ESS) is a rare biphasic neoplasm composed of a carcinomatous component (CaC) and a sarcomatous component (SaC). However, the genomic origin and gene signature of ESS remain unclear. Using whole-exome sequencing of laser-capture microdissection (LCM) tumor samples, we determined that CaC and SaC showed high mutational commonality, with the same top high-frequency mutant genes, mutation signatures, and tumor mutation burden; paired samples shared a median of 25.5% mutation sites. Focal gains were found on chromosomes 3q29, 5p15.33, and 11q13.3. Altered genes were mainly enriched in the RTK-RAS signaling pathway. Phylogenetic trees showed a monoclonal origin of ESS. The most frequently mutated oncogene in the trunk was TP53, followed by NFE2L2, KMT2D, and MUC16. Prognostic associations were found for CDC27, LRP2, APC, and SNAPC4. Our data highlight the monoclonal origin of ESS with TP53 as a potent driver oncogene, suggesting new targeted therapies and immunotherapies as treatment options. © 2024 The Pathological Society of Great Britain and Ireland.
Subject(s)
Esophageal Neoplasms , Esophageal Squamous Cell Carcinoma , Exome Sequencing , Mutation , Humans , Esophageal Squamous Cell Carcinoma/genetics , Esophageal Squamous Cell Carcinoma/pathology , Male , Female , Middle Aged , Esophageal Neoplasms/genetics , Esophageal Neoplasms/pathology , Aged , Biomarkers, Tumor/genetics , Laser Capture MicrodissectionABSTRACT
Ultrasound imaging is extensively used in biomedical science and clinical practice. Imaging resolution and tunability of imaging plane are key performance indicators, but both remain challenging to be improved due to the longer wavelength compared with light and the lack of zoom lens for ultrasound. Here, the ultrasound zoom imaging based on a stretchable planar metalens that simultaneously achieves the subwavelength imaging resolution and dynamic control of the imaging plane is reported. The proposed zoom imaging ultrasonography enables precise bone fracture diagnosis and comprehensive osteoporosis assessment. Millimeter-scale microarchitectures of the cortical bones at different depths can be selectively imaged with a 0.6-wavelength resolution. The morphological features of bone fractures, including the shape, size and position, are accurately detected. Based on the extracted ultrasound information of cancellous bones with healthy matrix, osteopenia and osteoporosis, a multi-index osteoporosis evaluation method is developed. Furthermore, it provides additional biological information in aspects of bone elasticity and attenuation to access the comprehensive osteoporosis assessment. The soft metalens also features flexibility and biocompatibility for preferable applications on wearable devices. This work provides a strategy for the development of high-resolution ultrasound biomedical zoom imaging and comprehensive bone quality diagnosis system.
ABSTRACT
Increasing neuroimaging studies have attempted to identify biomarkers of Huntington's disease (HD) progression. Here, we conducted voxel-based meta-analyses of voxel-based morphometry (VBM) studies on HD to investigate the evolution of gray matter volume (GMV) alterations and explore the effects of genetic and clinical features on GMV changes. A systematic review was performed to identify the relevant studies. Meta-analyses of whole-brain VBM studies were performed to assess the regional GMV changes in all HD mutation carriers, in presymptomatic HD (pre-HD), and in symptomatic HD (sym-HD). A quantitative comparison was performed between pre-HD and sym-HD. Meta-regression analyses were used to explore the effects of genetic and clinical features on GMV changes. Twenty-eight studies were included, comparing a total of 1811 HD mutation carriers [including 1150 pre-HD and 560 sym-HD] and 969 healthy controls (HCs). Pre-HD showed decreased GMV in the bilateral caudate nuclei, putamen, insula, anterior cingulate/paracingulate gyri, middle temporal gyri, and left dorsolateral superior frontal gyrus compared with HCs. Compared with pre-HD, GMV decrease in sym-HD extended to the bilateral median cingulate/paracingulate gyri, Rolandic operculum and middle occipital gyri, left amygdala, and superior temporal gyrus. Meta-regression analyses found that age, mean lengths of CAG repeats, and disease burden were negatively associated with GMV atrophy of the bilateral caudate and right insula in all HD mutation carriers. This meta-analysis revealed the pattern of GMV changes from pre-HD to sym-HD, prompting the understanding of HD progression. The pattern of GMV changes may be biomarkers for disease progression in HD.
Subject(s)
Gray Matter , Huntington Disease , Neuroimaging , Huntington Disease/diagnostic imaging , Huntington Disease/pathology , Huntington Disease/genetics , Humans , Gray Matter/diagnostic imaging , Gray Matter/pathology , Neuroimaging/methods , Brain/pathology , Brain/diagnostic imaging , Magnetic Resonance Imaging/methodsABSTRACT
Methods have been proposed in recent years aimed at pushing photoacoustic imaging resolution beyond the acoustic diffraction limit, among which those based on random speckle illumination show particular promise. In this Letter, we propose a data-driven deep learning approach to processing the added spatiotemporal information resulting from speckle illumination, where the neural network learns the distribution of absorbers from a series of different samplings of the imaged area. In ex-vivo experiments based on the tomography configuration with prominent artifacts, our method successfully breaks the acoustic diffraction limit and delivers better results in identifying individual targets when compared against a selection of other leading methods.
ABSTRACT
OBJECTIVES: To develop a robust algorithm for estimating ultrasonic axial transmission velocity from neonatal tibial bone, and to investigate the relationships between ultrasound velocity and neonatal anthropometric measurements as well as clinical biochemical markers of skeletal health. METHODS: This study presents an unsupervised learning approach for the automatic detection of first arrival time and estimation of ultrasonic velocity from axial transmission waveforms, which potentially indicates bone quality. The proposed method combines the ReliefF algorithm and fuzzy C-means clustering. It was first validated using an in vitro dataset measured from a Sawbones phantom. It was subsequently applied on in vivo signals collected from 40 infants, comprising 21 males and 19 females. The extracted neonatal ultrasonic velocity was subjected to statistical analysis to explore correlations with the infants' anthropometric features and biochemical indicators. RESULTS: The results of in vivo data analysis revealed significant correlations between the extracted ultrasonic velocity and the neonatal anthropometric measurements and biochemical markers. The velocity of first arrival signals showed good associations with body weight (ρ = 0.583, P value <.001), body length (ρ = 0.583, P value <.001), and gestational age (ρ = 0.557, P value <.001). CONCLUSION: These findings suggest that fuzzy C-means clustering is highly effective in extracting ultrasonic propagating velocity in bone and reliably applicable in in vivo measurement. This work is a preliminary study that holds promise in advancing the development of a standardized ultrasonic tool for assessing neonatal bone health. Such advancements are crucial in the accurate diagnosis of bone growth disorders.
Subject(s)
Tibia , Ultrasonography , Unsupervised Machine Learning , Humans , Infant, Newborn , Ultrasonography/methods , Female , Male , Tibia/diagnostic imaging , Tibia/physiology , Phantoms, Imaging , Algorithms , Reproducibility of ResultsABSTRACT
Recently, ultrasound transit time spectroscopy (UTTS) was proposed as a promising method for bone quantitative ultrasound measurement. Studies have showed that UTTS could estimate the bone volume fraction and other trabecular bone structure in ultrasonic through-transmission measurements. The goal of this study was to explore the feasibility of UTTS to be adapted in ultrasonic backscatter measurement and further evaluate the performance of backscattered ultrasound transit time spectrum (BS-UTTS) in the measurement of cancellous bone density and structure. First, taking ultrasonic attenuation into account, the concept of BS-UTTS was verified on ultrasonic backscatter signals simulated from a set of scatterers with different positions and intensities. Then, in vitro backscatter measurements were performed on 26 bovine cancellous bone specimens. After a logarithmic compression of the BS-UTTS, a linear fitting of the log-compressed BS-UTTS versus ultrasonic propagated distance was performed and the slope and intercept of the fitted line for BS-UTTS were determined. The associations between BS-UTTS parameters and cancellous bone features were analyzed using simple linear regression. The results showed that the BS-UTTS could make an accurate deconvolution of the backscatter signal and predict the position and intensity of the simulated scatterers eliminating phase interference, even the simulated backscatter signal was with a relatively low signal-to-noise ratio. With varied positions and intensities of the scatterers, the slope of the fitted line for the log-compressed BS-UTTS versus ultrasonic propagated distance (i.e., slope of BS-UTTS for short) yield a high agreement (r2 = 99.84%-99.96%) with ultrasonic attenuation in simulated backscatter signal. Compared with the high-density cancellous bone, the low-density specimen showed more abundant backscatter impulse response in the BS-UTTS. The slope of BS-UTTS yield a significant correlation with bone mineral density (r = 0.87; p < 0.001), BV/TV (r = 0.87; p < 0.001), and cancellous bone microstructures (r up to 0.87; p < 0.05). The intercept of BS-UTTS was also significantly correlated with bone densities (r = -0.87; p < 0.001) and trabecular structures (|r|=0.43-0.80; p < 0.05). However, the slope of the BS-UTTS underestimated attenuation when measurements were performed experimentally. In addition, a significant non-linear relationship was observed between the measured attenuation and the attenuation estimated by the slope of the BS-UTTS. This study demonstrated that the UTTS method could be adapted to ultrasonic backscatter measurement of cancellous bone. The derived slope and intercept of BS-UTTS could be used in the measurement of bone density and microstructure. The backscattered ultrasound transit time spectroscopy might have potential in the diagnosis of osteoporosis in the clinic.
Subject(s)
Bone and Bones , Cancellous Bone , Animals , Cattle , Cancellous Bone/diagnostic imaging , Scattering, Radiation , Ultrasonography/methods , Bone and Bones/diagnostic imaging , Bone Density/physiology , Spectrum Analysis/methodsABSTRACT
Ultrasound imaging for bone is a difficult task in the field of medical ultrasound. Compared with other phase array techniques, the synthetic aperture (SA) has a better lateral resolution but a limited imaging depth due to the limited ultrasonic energy emitted by the single emitter in each transmission. In contrast, the virtual source (VS) synthetic aperture allows a simultaneous multi-element emission and could provide a higher ultrasonic incident energy in each transmission. Therefore, the VS might achieve a high imaging quality at a deeper depth for bone imaging than the traditional SA. In this study, we proposed the virtual source phase shift migration (VS-PSM) method to achieve ultrasonic imaging of the deeper bone defect featured in the multilayer structure. The proposed VS-PSM method was validated using standard soft tissue phantom and printed bone phantom with artificial defects. The image quality was evaluated in terms of contrast-to-noise ratios (CNR) and amplitudes of scatters and defects at different imaging depths. The results showed that the VS-PSM method could achieve a high imaging quality of the soft tissues with a significant improvement in the scattering amplitude and without a significant sacrifice of the lateral and axial resolution. The PSM was superior to the DAS in suppressing the background noise in the images. Compared with the traditional SA-PSM, the VS-PSM method could image deeper bone defects at different ultrasonic frequencies, with an average improvement of 50% in CNR. In conclusion, this study demonstrated that the proposed VS-PSM method could image deeper bone defects and might help the diagnosis of bone disease using ultrasonic imaging.
ABSTRACT
Litsea cubeba, which is found widely distributed across the Asian region, functions as both an economic tree and a medicinal plant with a rich historical background. Previous investigations into its chemical composition and biological activity have predominantly centered on volatile components, leaving the study of non-volatile components relatively unexplored. In this study, we employed UPLC-HRMS technology to analyze the non-volatile components of L. cubeba branches and leaves, which successfully resulted in identifying 72 constituents. Comparative analysis between branches and leaves unveiled alkaloids, organic acids, and flavonoids as the major components. However, noteworthy differences in the distribution of these components between branches and leaves were observed, with only eight shared constituents, indicating substantial chemical variations in different parts of L. cubeba. Particularly, 24 compounds were identified for the first time from this plant. The assessment of antioxidant activity using four methods (ABTS, DPPH, FRAP, and CUPRAC) demonstrated remarkable antioxidant capabilities in both branches and leaves, with slightly higher efficacy observed in branches. This suggests that L. cubeba may act as a potential natural antioxidant with applications in health and therapeutic interventions. In conclusion, the chemical composition and antioxidant activity of L. cubeba provides a scientific foundation for its development and utilization in medicine and health products, offering promising avenues for the rational exploitation of L. cubeba resources in the future.
Subject(s)
Litsea , Oils, Volatile , Plants, Medicinal , Antioxidants/pharmacology , Antioxidants/analysis , Oils, Volatile/chemistry , Litsea/chemistry , Plant Leaves/chemistryABSTRACT
BACKGROUND: Percutaneous transhepatic cholangioscopic lithotripsy (PTCSL) is a minimally invasive treatment for hepatolithiasis. But it may make a long cycle of treatment so that it was further improved to complete the percutaneous hepatic choledochotomy and choledochoscopic lithotripsy in phase I surgery. The aim of this study was to evaluate the efficacy of the modified technique comparing with laparoscopic choledochotomy. METHODS: Retrospective analysis of the clinical data of patients with hepatolithiasis or choledocholithiasis consulted at our hospital from February 2018 to December 2021. The cases were divided into two groups according to surgical modality, intraoperative ultrasound-guided percutaneous transhepatic cholangioscopic lithotripsy (IUG-PTCSL) and laparoscopic choledochotomy lithotripsy (LC-L). Contrast analysis determined the advantages of the two approaches. RESULTS: IUG-PTCSL was performed in 44 patients, aged 58.14 ± 14.01 years, including 9 male and 35 female. There were 15 patients underwent LC-L, aged 62.13 ± 15.03 years, including 1 male and 14 female. There was not statistically significant difference in the composition of patients' age and sex between the two groups (p = 0.356, 0.219). The success rate of intraoperative ultrasound-guided percutaneous hepatic bile duct puncture was 100% followed with the success rate of hepatocholangiostomy was 100%. Although 1 (1/44) patient showed significant bleeding during choledochoscopic lithotripsy and was converted to open choledochotomy for stone extraction, 43 patients completed IUG-PTCSL with the rate of phase I surgical stones removal was 81.40% (35/43), whereas the stones removal rate of LC-L was 66.67% (10/15). There was not statistically significant difference between them (p = 0.067). Both the groups showed no significant complications with the postoperative hospital stay of 8 (6, 10) days and 10 (8, 11) days, respectively, and the difference was statistically significant (p = 0.028). CONCLUSION: Intraoperative ultrasound-guided percutaneous transhepatic cholangioscopy might be a safe and reliable ideal method for bile duct stones with the advantages of rapid recovery for patients. Intraoperative ultrasound-guided percutaneous hepatocholangiostomy may be the key technique for the successful completion of the surgery.
Subject(s)
Choledocholithiasis , Laparoscopy , Lithiasis , Lithotripsy , Liver Diseases , Humans , Male , Female , Choledocholithiasis/diagnostic imaging , Choledocholithiasis/surgery , Liver Diseases/diagnostic imaging , Liver Diseases/surgery , Lithiasis/surgery , Retrospective Studies , Treatment Outcome , Laparoscopy/methods , Lithotripsy/methods , Ultrasonography, InterventionalABSTRACT
PURPOSE: Aerobic exercise has shown beneficial effects in the prevention and treatment of non-alcoholic fatty liver disease (NAFLD). Nevertheless, the regulatory mechanism is not turely clear. Therefore, we aim to clarify the possible mechanism by investigating the effects of aerobic exercise on NAFLD and its mitochondrial dysfunction. METHODS: NAFLD rat model was established by feeding high fat diet. and used oleic acid (OA) to treat HepG2 cells. Changes in histopathology, lipid accumulation, apoptosis, body weight, and biochemical parameters were assessed. In addition, antioxidants, mitochondrial biogenesis and mitochondrial fusion and division were assessed. RESULTS: The obtained in vivo results showed that aerobic exercise significantly improved lipid accumulation and mitochondrial dysfunction induced by HFD, activated the level of Sirtuins1 (Srit1), and weakened the acetylation and activity of dynamic-related protein 1 (Drp1). In vitro results showed that activation of Srit1 inhibited OA-induced apoptosis in HepG2 cells and alleviated OA-induced mitochondrial dysfunction by inhibiting Drp1 acetylation and reducing Drp1 expression. CONCLUSION: Aerobic exercise alleviates NAFLD and its mitochondrial dysfunction by activating Srit1 to regulate Drp1 acetylation. Our study clarifies the mechanism of aerobic exercise in alleviating NAFLD and its mitochondrial dysfunction and provides a new method for adjuvant treatment of NAFLD.
Subject(s)
Dynamins , Non-alcoholic Fatty Liver Disease , Sirtuin 1 , Animals , Humans , Rats , Acetylation , Apoptosis , Dynamins/genetics , Hep G2 Cells , Non-alcoholic Fatty Liver Disease/genetics , Non-alcoholic Fatty Liver Disease/therapy , Oleic Acid , Sirtuin 1/genetics , Physical Conditioning, Animal , HepatocytesABSTRACT
BACKGROUND AND IMPORTANCE: Chordomas are centrally located, expansile soft tissue neoplasms that arise from the remnants of the embryological notochord. Hemorrhagic presentation is exceedingly rare and can resemble pituitary apoplexy. Moreover, a purely intrasellar location of a chordoma is extremely uncommon. We report a case of a hemorrhagic intrasellar chordoma in an adult male, which presented similarly to pituitary apoplexy and was resolved with surgical resection. CLINICAL PRESENTATION: A 69-year-old male presented with a 4 week history of acute onset headache and concurrent diplopia, with significantly reduced testosterone and slightly reduced cortisol. His left eye demonstrated a sixth cranial nerve palsy. Magnetic resonance imaging of the brain showed a large hemorrhagic mass in the pituitary region with significant compression of the left cavernous sinus and superior displacement of the pituitary gland. The patient underwent an endoscopic endonasal transsphenoidal approach for the resection of the lesion. Near total resection was achieved. Final pathology revealed chordoma with evidence of intratumoral hemorrhage, further confirmed by immunopositive stain for brachyury. Post-operatively, the patient had improved diplopia and was discharged home on low dose hydrocortisone. At 3-month follow-up, his diplopia was resolved and new MRI showed stable small residual disease. CONCLUSIONS: Apoplectic chordomas are uncommon given chordoma's characteristic lack of intralesional vascularity and represent a diagnostic challenge in the sellar region. Our unique case demonstrates that despite our initial impression of pituitary apoplexy, this was ultimately a case of apoplectic chordoma that responded well to endoscopic endonasal surgery.
Subject(s)
Adenoma , Chordoma , Pituitary Apoplexy , Pituitary Neoplasms , Adult , Humans , Male , Aged , Pituitary Apoplexy/diagnosis , Pituitary Apoplexy/etiology , Pituitary Apoplexy/surgery , Chordoma/diagnosis , Chordoma/surgery , Diplopia/etiology , Adenoma/surgery , Hemorrhage , Pituitary Neoplasms/diagnosis , Pituitary Neoplasms/surgery , Pituitary Neoplasms/pathologyABSTRACT
CONTEXT: Sinisan (SNS) has been used to treat psychosomatic diseases of the digestive system. But little is known about how SNS affects water immersion restraint stress (WIRS). OBJECTIVE: To study the effects of SNS on colonic tissue injury in the WIRS model. MATERIALS AND METHODS: Forty-eight Kunming (KM) mice were randomized into 6 groups (n = 8): The control and WIRS groups receiving deionized water; the SNS low-dose (SL, 3.12 g/kg/d), SNS middle-dose (SM, 6.24 g/kg/d), SNS high-dose (SH, 12.48 g/kg/d), and diazepam (DZ, 5 mg/kg/d) groups; each with two daily administrations for 5 consecutive days. The 5 treatment groups were subjected to WIRS for 24 h on day 6. The effects of SNS on colon tissue injury caused by WIRS were assessed by changes in colon histology, inflammatory cytokines, brain-gut peptides, and tight junction (TJ) proteins levels. 16S rRNA gene sequencing was used to detect the regulation of the gut microbiota. RESULTS: SNS pretreatment significantly reduced TNF-α (0.75- to 0.81-fold), IL-6 (0.77-fold), and IFN-γ (0.69-fold) levels; and increased TJ proteins levels, such as ZO-1 (4.06- to 5.27-fold), claudin-1 (3.33- to 5.14-fold), and occludin (6.46- to 11.82-fold). However, there was no significant difference between the levels of substance P (SP) and vasoactive intestinal peptide (VIP) in the control and WIRS groups. SNS regulated the composition of gut microbiota in WIRS mice. CONCLUSION: The positive effects of SNS on WIRS could provide a theoretical basis to treat stress-related gastrointestinal disorders.
Subject(s)
Gastrointestinal Microbiome , Mice , Animals , Intestinal Mucosa , Immersion , RNA, Ribosomal, 16S , Colon/pathology , Tight Junction Proteins/metabolism , Water/pharmacologyABSTRACT
BACKGROUND: Measurement of the posterior tibial slope (PTS) angle has important applications in total knee replacement surgery, high tibial osteotomy, and anterior cruciate ligament reconstruction. This study aimed to determine the mean PTS of knee joints in healthy Chinese adults, and provide data to guide knee surgery in China. METHODS: A retrospective analysis of 1257 (n = 1233, 50.4% male) plain X-ray films of participants aged 25-59 years was performed. The picture archiving and communication system was used for PTS measurement. The PTS was defined as the angle between the vertical line of the tangent of the anterior tibial cortex of the proximal tibia, and the tangent line of the tibial cortex. Two imaging physicians conducted the PTS measurements independently, and both the inter- and intraclass correlation coefficients (ICCs) were calculated. RESULTS: The mean PTS value was 7.68 ± 3.84° (range: 0-21°). The left PTS was significantly smaller in males than in females (7.22 ± 3.89 vs 8.05 ± 3.60; P = 0.005). Additionally, the PTS in participants aged 25-29 years was significantly larger than that in the other age groups (Left side: 8.64 ± 3.73 vs 6.92 ± 3.42, 7.42 ± 3.75, 7.53 ± 3.98; P < 0.001 and Right side: 8.68 ± 3.84 vs 7.48 ± 4.21, 7.13 ± 3.64, 7.66 ± 3.80; P = 0.004). There were no significant differences in PTS between the left and right sides. Two-way analysis of variance suggested that the differences in PTS between age groups were not affected by sex. The interobserver ICC was 0.91 (95% confidence interval [CI]: 0.85-0.94), and the intraobserver ICC was 0.90 (95% CI: 0.82-0.94). CONCLUSIONS: This study demonstrated that there were significant differences in PTS based on sex and age, highlighting the need to provide individualized treatment for knee surgery. It provided valuable information regarding the normal PTS values in Chinese adults and presented regionalised data to guide knee surgery.
Subject(s)
Anterior Cruciate Ligament Reconstruction , Arthroplasty, Replacement, Knee , Adult , Arthroplasty, Replacement, Knee/methods , Female , Humans , Knee Joint/diagnostic imaging , Knee Joint/surgery , Male , Retrospective Studies , Tibia/diagnostic imaging , Tibia/surgeryABSTRACT
False localizing signs (FLS) and other misleading neurological signs have long been an intractable aspect of neurocritical care. Because they suggest an incorrect location or etiology of the pathological lesion, they have often led to misdiagnosis and mismanagement of the patient. Here, we reviewed the existing literature to provide an updated, comprehensive descriptive review of these difficult to diagnose signs in neurocritical care. For each sign presented, we discuss the non-false localizing presentation of symptoms, the common FLS or misleading presentation, etiology/pathogenesis of the sign, and diagnosis, as well as any other clinically relevant considerations. Within cranial neuropathies, we cover cranial nerves III, IV, V, VI, VII, VIII, as well as multiple cranial nerve involvement of IX, X, and XII. FLS ophthalmologic symptoms indicate diagnostically challenging neurological deficits, and here we discuss downbeat nystagmus, ping-pong-gaze, one-and-a-half syndrome, and wall-eyed bilateral nuclear ophthalmoplegia (WEBINO). Cranial herniation syndromes are integral to any discussion of FLS and here we cover Kernohan's notch phenomenon, pseudo-Dandy Walker malformation, and uncal herniation. FLS in the spinal cord have also been relatively well documented, but in addition to compressive lesions, we also discuss newer findings in radiculopathy and disc herniation. Finally, pulmonary syndromes may sometimes be overlooked in discussions of neurological signs but are critically important to recognize and manage in neurocritical care, and here we discuss Cheyne-Stokes respiration, cluster breathing, central neurogenic hyperventilation, ataxic breathing, Ondine's curse, and hypercapnia. Though some of these signs may be rare, the framework for diagnosing and treating them must continue to evolve with our growing understanding of their etiology and varied presentations.
Subject(s)
Cranial Nerve Diseases , Cranial Nerve Diseases/diagnosis , Humans , Paralysis , Spinal CordABSTRACT
OBJECTIVES: Aneurysmal subarachnoid hemorrhage (aSAH) is an emergent neurosurgical condition associated with high morbidity and mortality. The prognostic significance of baseline frailty status in aSAH patients has not been previously evaluated in a large, nationally representative sample. MATERIALS AND METHODS: Clinical outcomes data from the National Inpatient Sample from 2010-2018 were compared among sub-cohorts stratifying admissions by increasing frailty thresholds [(assessed using the 11-point modified frailty index (mFI-11)]. The previously validated NIS-SAH Severity Score (NIS-SSS) and NIS-SAH Outcome Measure (NIS-SOM) were utilized. Complex samples multivariable logistic regression and receiver operating characteristic (ROC) curve analyses were performed to assess adjusted associations and discrimination of frailty for endpoints. RESULTS: Among 64,102 aSAH hospitalizations (mean age 55.4 years), 20.4% of admissions were classified as robust (mFI=0), 43.4% as pre-frail (mFI = 1), 24.9% as frail (mFI = 2), and 11.2% as severely frail (mFI ≥ 3). Following multivariable analysis adjusting for age and aSAH severity, increasing frailty was independently associated with NIS-SOM (OR = 1.15, 95% CI 1.09-1.21; p < 0.001), extended length of hospital stay (eLOS) (OR = 1.08, 1.02-1.13; p = 0.008), neurological complications (OR = 1.08, 1.03-1.13; p < 0.001), and medical complications (OR = 1.14, 1.08-1.21; p < 0.001). Based on ROC curve analysis, frailty achieved an AUC of 0.59 (0.58-0.60) and 0.54 (0.53-0.55) for NIS-SOM and eLOS, respectively. Age and NIS-SSS demonstrated significantly greater discrimination for NIS-SOM [AUC 0.69 (0.68-0.70) and 0.79 (0.78-0.80), respectively), while NIS-SSS achieved significantly greater discrimination for eLOS [(AUC 0.74 (0.73-0.75)] in comparison to both age and frailty. CONCLUSIONS: This national database evaluation of frailty in aSAH patients demonstrates an independent association between increasing frailty and poor functional outcome. Age and aSAH severity, however, may be more robust prognostic factors.
Subject(s)
Frailty , Subarachnoid Hemorrhage , Frailty/complications , Frailty/diagnosis , Frailty/epidemiology , Hospitalization , Humans , Inpatients , Length of Stay , Middle Aged , Retrospective Studies , Subarachnoid Hemorrhage/complications , Subarachnoid Hemorrhage/diagnosis , Subarachnoid Hemorrhage/therapy , Treatment OutcomeABSTRACT
As fluorescence is the major limitation in Raman scattering, near-infrared excitation wavelength (>780nm) is preferred for fluorescence suppression in Raman spectroscopy. To reduce the risk of fluorescence interference, we developed a dual-wavelength excitation combined Raman spectroscopy (DWECRS) system at 785 and 830 nm. By a common optical path, each laser beam was focused on the same region of the sample by a single objective lens, and the dual-wavelength excitation Raman spectra were detected by a single CCD detector; in addition, 785 and 830 nm excitation Raman spectra can be directly constructed as combined Raman spectrum in the DWECRS system. The results of pure peanut oil and glycerol indicate that the combined Raman spectrum cannot only reduce fluorescence interference but also keep a high signal-to-noise ratio in the high-wavenumber region. The results of dye-ethanol solutions with different concentrations show that the handheld DWECRS system can be used as a smart method to dodge strong fluorescence. Furthermore, we developed a peak intensity ratio method with the DWECRS system to distinguish different types of edible oils. The peak intensity ratio distribution chart of edible oils showed each oil normalized center was relatively independent and nonoverlapped, which can be used as the basis of edible oil classification analysis. In the future, the DWECRS system has potential to be used as a tool for more complex applications.
ABSTRACT
In recognition of the misuse risks of fentanyl, there is an urgent need to develop a useful and rapid analytical method to detect and monitor the opioid drug. The surface-enhanced shifted excitation Raman difference spectroscopy (SE-SERDS) method has been demonstrated to suppress background interference and enhance Raman signals. In this study, the SE-SERDS method was used for trace detection of fentanyl in beverages. To prepare the simulated illegal drug-beverages, fentanyls were dissolved into distilled water or Mizone as a series of test samples. Based on our previous work, the surface-enhanced Raman spectroscopy detection was performed on the beverages containing fentanyl by the prepared AgNPs and the SE-SERDS spectra of test samples were collected by the dual-wavelength rapid excitation Raman difference spectroscopy system. In addition, the quantitative relationship between fentanyl concentrations and the Raman peaks was constructed by the Langmuir equation. The experimental results show that the limits of quantitation for fentanyl in distilled water and Mizone were 10 ng/mL and 200 ng/mL, respectively; the correlation coefficients for the nonlinear regression were as high as 0.9802 and 0.9794, respectively; and the relative standard deviation was less than 15%. Hence, the SE-SERDS method will be a promising method for the trace analyses of food safety and forensics.
Subject(s)
Analgesics, Opioid/analysis , Beverages/analysis , Fentanyl/analysis , Spectrum Analysis, Raman/methods , Biomedical Enhancement , Food Safety , Humans , Limit of Detection , Surface PropertiesABSTRACT
BACKGROUND: A 13-year-old female patient was diagnosed with a tectal glioma (TG), a subgroup of astrocytoma that can result in obstructive hydrocephalus secondary to aqueductal stenosis. Endoscopic third ventriculostomy (ETV) is used to treat this type of hydrocephalus with a good success rate. Our institution performs ETV and Ommaya reservoir (OR) placement in these cases. The OR allows measurement of intracranial pressure (ICP) and cerebrospinal fluid (CSF) access and a method for performing ventricular dye studies to evaluate third ventricular stoma (TVS) patency. In this case, a porencephalic cyst (PC) developed around the OR's ventricular catheter (OVC) two and a half months after surgery. CONCLUSION: The PC is thought to have developed in association with TVS stoma closure and resolved after ETV revision.
Subject(s)
Cysts , Hydrocephalus , Neuroendoscopy , Third Ventricle , Adolescent , Cerebrospinal Fluid Shunts , Cysts/etiology , Cysts/surgery , Female , Humans , Hydrocephalus/etiology , Hydrocephalus/surgery , Third Ventricle/diagnostic imaging , Third Ventricle/surgery , Treatment Outcome , VentriculostomyABSTRACT
OBJECTIVE: To conduct a case series analysis on Professor Wang Qi's prescriptions for oligoasthenospermia and a preliminary discussion on the clinical application of the pathogenesis theory of "kidney deficiency with dampness, heat, stasis, toxin and parasites" so as to provide some reference for the diagnosis and treatment of oligoasthenospermia by traditional Chinese medicine (TCM). METHODS: We selected 13 representative cases of oligoasthenospermia treated by Professor Wang Qi, analyzed the basic conditions of the patients, changes of the disease and prescriptions used, and investigated the treatment of oligoasthenospermia in view of Professor Wang Qi's TCM theory on andrology. RESULTS: Excellent therapeutic effect was achieved in 7, indefinite effect in 5 and no effect in 1 of the 13 cases. Totally 38 prescriptions were employed in the treatment, of which Bajitian was used in 30, Tusizi in 27, Gouqizi in 25, Sangshen in 25, Shuizhi in 24 and Danggui in 22. The drugs used in the treatment of 10 or more patients included Bajitian in 12, Sangshen in 11, Shuizhi in 11, Tusizi in 10 and Gouqizi in 10 cases. CONCLUSIONS: Professor Wang Qi's prescriptions are effective for the treatment of oligoasthenospermia and the pathogenesis theory of "kidney deficiency with dampness, heat, stasis, toxin and parasites" is valuable in guiding the clinical diagnosis and treatment in traditional Chinese medicine.
Subject(s)
Medicine, Chinese Traditional , Qi , Humans , PrescriptionsABSTRACT
OBJECTIVE: To analyze the medication rules for oligoasthenozoospermia (OAZ) observed by Wang Qi, an academician, master of Traditional Chinese Medicine (TCM) and initiator of andrology in TCM. METHODS: We collected the outpatient cases of OAZ treated by Wang Qi and established a database of clinical medical records using the TCM Inheritance Auxiliary Platform. Employing the integrated rule-based system for analysis of the software, we modified the mutual information method, complex system entropy clustering analysis and other data mining methods, and summarized the medication rules Wang Qi followed in the treatment of OAZ. RESULTS: A total of 134 prescriptions made by Wang Qi for the treatment of OAZ were collected, involving 110 TCM drugs, which are mainly neutral and warm in nature and taste sweet and mostly act through the liver and kidney meridians. The core formula ingredients of the prescriptions included Morinda officinalis, Cuscuta chinensis, Lycium barbarum, Mulberry, Angelica sinensis, Astragalus mongholicus and Fish Maw, and most frequently Morinda officinalis, Cuscuta chinensis, Lycium barbarum and Mulberry. CONCLUSIONS: Wang Qi holds that kidney deficiency, dampness-heat, blood stasis and toxin are the main pathogenic factors for OAZ. The basic treatment of OAZ is to invigorate the kidney and replenish the essence, and meanwhile activate blood circulation, dissipate stasis and eliminate dampness-heat.