Detection of Asymptomatic Carotid Artery Stenosis in High-Risk Individuals of Stroke Using a Machine-Learning Algorithm.

Objective Asymptomatic carotid stenosis (ACS) is closely associated to the incidence of severe cerebrovascular diseases. Early identifying the individuals with ACS and its associated risk factors could be beneficial for primary prevention of stroke. This study aimed to investigate a machine-learning algorithm for the detection of ACS among high-risk population of stroke based on the associated risk factors.Methods A novel model of machine learning was utilized to screen the associated predictors of ACS based on 30 potential risk factors. The algorithm of this model adopted a random forest pattern based on the training data and then was verified using the testing data. All of the original data were retrieved from the China National Stroke Screening and Prevention Project (CNSSPP), including demographic, clinical and laboratory characteristics. The individuals with high risk of stroke were enrolled and randomly divided into a training group and a testing group at a ratio of 4:1. The identification of carotid stenosis by carotid artery duplex scans was set as the golden standard. The receiver operating characteristic (ROC) curve and the area under the curve (AUC) was used to evaluate the efficacy of the model in detecting ACS.Results Of 2841 high risk individual of stroke enrolled, 326 (11.6%) were diagnosed as ACS by ultrasonography. The top five risk factors contributing to ACS in this model were identified as family history of dyslipidemia, high level of low-density lipoprotein cholesterol (LDL-c), low level of high-density lipoprotein cholesterol (HDL-c), aging, and low body mass index (BMI). Their weights were 11.8%, 7.6%, 7.1%, 6.1%, and 6.1%, respectively. The total weight of the top 15 risk factors was 85.5%. The AUC values of the model for detecting ACS with training dataset and testing dataset were 0.927 and 0.888, respectively.Conclusions This study demonstrated that the machine-learning algorithm could be used to identify the risk factors for ACS among high risk population of stroke. Family history of dyslipidemia may be the most important risk factor for ACS. This model could be a suitable tool to optimize the clinical approach for the primary prevention of stroke.

Flow field study of radiofrequency ablation of renal sympathetic nerve: Numerical simulation and PIV experiments.

Renal sympathetic denervation (RSD) is a new method for the treatment of resistant hypertension (RH). However, few studies have focused on the effects of RSD on blood flow and the interaction between temperature field and flow field. In this paper, firstly, we designed a numerical simulation of electromagnetic field, flow field and temperature field coupling by finite element method. Secondly, numerical simulation results were verified by particle image velocimetry (PIV) and vitro experiment. From the simulation results, when the flow velocity increases to 0.05 m/s, the turbulence near the electrode disappeared and flow state became uniform laminar flow. With the increases of flow velocity (0 m/s to 0.1 m/s), temperature rise of the renal artery, the electrode tip and blood decreased from 13°C, 24°C and 5.4°C to 9.3°C, 9.7°C and 0.2°C, respectively. From PIV experiment and vitro experiment results, when the flow rate increases to 0.5 L/min, it appeared similar phenomenon with the velocity of 0.05 m/s in simulation. With the increases of flow rate (0 L/min to 0.8 L/min), temperature rise of three points decreased from 11.2°C, 20.5°C and 3.6°C to 7.8°C, 8.5°C, and 0.4°C, respectively. When the blood flow rate exceeds 0.5 L/min, there is no large velocity gradient and reflux area in the flow field, so there will be no hemolysis and thrombosis. Therefore, the temperature field has less influence on the flow field. With the increase of flow rate, the temperature at all three points decreases. Therefore, the flow field has an effect on the temperature field. But the central temperature of renal artery can still reach the treatment target in which temperature rises to be more than 6°C. Therefore, this study preliminarily verified the safety and effectiveness of RSD.

Conversion to resectability using transcatheter arterial chemoembolization alternating with mFOLFOX6 in patients with colorectal liver metastases.

BACKGROUND: Colorectal cancer is one of the most common malignancies in the world, and about 25% of colorectal cancer patients present with colorectal cancer liver metastases (CRCLM) even at new diagnosis. The study was to evaluate the safety and efficacy of transcatheter arterial chemoembolization (TACE) alternating with mFOLFOX6 in Chinese patients with unresectable CRCLM. MATERIALS AND METHODS: In this study, by combining the systemic and regional treatment, the resectability rate, overall survival, and progression-free survival were measured with addition of TACE. Included patients had Eastern Cooperative Oncology Group performance status 0-2. Sixty-two patients received mFOLFOX6 plus one TACE after 2 weeks of chemotherapy; after 2 weeks, the next periodical treatment repeated. Patients received operation when the liver metastases were converted to resectability or severe tumor-associated complications occurred. RESULTS: We found that 28 patients (45.2%) patients received operation after the treatment of TACE combined with systemic chemotherapy. The median time from initial treatment to the operation was 6 months. The median follow-up period was 41 months in all the patients. The 3-year survival rate of resected patients and unresected patients was 54% and 17%, respectively. Post-TACE syndrome was the major adverse reaction (81%). Other adverse reactions were neutropenia, nausea, and neurotoxicity. No patient died of the adverse reactions. The resection rate was related to hepatic segments and vasculature involvement. CONCLUSION: Taken together, TACE alternating with mFOLFOX6 has been proved to be safe and effective for CRCLM treatment to improve resection rate and prolong the survival time.

Cytotoxic Triterpenoids from Roots of Actinidia chinensis.

Phytochmical investigation of roots of Actinidia chinensisPlanch. led to the isolation triterpenoids 1 - 16, including a new compound 2α,3α,23,24-tetrahydroxyursa-12,20(30)-dien-28-oic acid (1). Their structures were identified on the basis of spectroscopic analysis, including 1D- and 2D-NMR, HR-ESI mass spectrometry, and by comparison with the literatures. The cytotoxicities of triterpenoids 1 - 16 against a panel of cultured human cancer cell lines (HepG2, A549, MCF-7, SK-OV-3, and HeLa) were evaluated. The new compound 1 exhibited moderate antitumor activities with IC50 values of 19.62 ± 0.81, 18.86 ± 1.56, 45.94 ± 3.62, 62.41 ± 2.29, and 28.74 ± 1.07 µm, respectively. The experiment data might be available to explain the use of roots of A. chinensis to treat various cancers in traditional Chinese medicine.

[Chemical constituents from roots of Actinidia rufa and their cytotoxicity].

To investigate the chemical compounds from the roots of Actinidia rufa, nine compounds were isolated by various column chromatography on silica gel and Sephadex LH-20, and high performance liquid chromatography (HPLC). Their structures were elucidated as 2α, 3ß, 19α, 23, 24-pentahydroxyurs-12-en-28-oic acid-28-O-ß-D-glucopyranoside (1), 2α, 3α, 19α, 24-tetrahydroxyurs-12-en-28-oic acid-28-O-ß-D-glucopyranoside (2), 2α, 3α, 24-trihydroxyurs-12-en-28-oic acid (3), 2α, 3α, 24-trihydroxyolean-12-en-28-oic acid (4), 2α, 3α, 23, 24-tetrahydroxyurs -12-en-28-oic acid (5), 2α, 3ß, 23, 24-tetrah-ydroxyurs-12-en-28-oic acid (6), 2α, 3ß, 23-trihydroxy-12-en-28-oic acid (7), 2α, 3ß, 23-trihydroxyurs-12, 20(30)-dien-28-oic acid (8), and 2α, 3α, 23-trihydroxyurs-12, 20(30)-dien-28-oic acid (9). Compounds 1 and 2 were isolated from the Actinidia genus for the first time. Compounds 2, 3, and 4 showed cytotoxic activity against human SKVO3 and TPC-1 cancer cell lines with IC50 values ranging from 10.99 to 16.41 µmol•L⁻¹, compounds 3 and 4 have cytotoxic activity against human HeLa cancer cell line with IC50 values of 15.53 and 13.07 µmol•L⁻¹, respectively.

Fusion of detected multi-channel maternal electrocardiogram (ECG) R-wave peak locations.

BACKGROUND: Almost all promising non-invasive foetal ECG extraction methods involve accurately determining maternal ECG R-wave peaks. However, it is not easy to robustly detect accurate R-wave peaks of the maternal ECG component in an acquired abdominal ECG since it often has a low signal-to-noise ratio (SNR), sometimes containing a large foetal ECG component or other noises and interferences. This paper discusses, under the condition of acquiring multi-channel abdominal ECG signals, how to improve the robustness of maternal ECG R-wave peak detection. METHODS: On the basis of summarising the current single channel ECG R-wave peak detection methods, the paper proposed a specific fusion algorithm of detected multi-channel maternal ECG R-wave peak locations. The proposed entire algorithm was then tested using two databases; one database, created by us, was composed of 343 groups of 8-channel data collected from 78 pregnant women, and the other one, called the challenge database, was from the Physionet/Computing in Cardiology Challenge 2013, including 175 groups of 4-channel data. When using these databases, each group of data was classified into two parts, called the training part and the validation test part respectively; the training part was the first 8.192 s of each group of data and the validation test part was the next 8.192 s. RESULTS: To show the results, three evaluation parameters-sensitivity (Se), positive predictive value (PPV) and F1-are used. The validation test results for the database we collected are Se = 99.93 %, PPV = 99.98 %, and F1 = 99.95 %, while the results for the challenge database are Se = 99.91 %, PPV = 99.86 %, and F1 = 99.88 %. CONCLUSION: The results of the test show that the robustness of our proposed whole fusion algorithm was superior to that of other outstanding algorithms for maternal R-wave detection, and is much better than that of single channel maternal R-wave detection algorithms.

[Research on ground scenery spectral radiation source with tunable spectra].

A spectrum-tunable ground scenery spectrum radiation source, using LEDs and bromine tungsten lamp as luminescence media, was introduced. System structure and control of the spectrum radiation source was expounded in detail. In order to simulate various ground scenery spectrum distribution with different shapes, a ground scenery spectral database was established in the control system. An improved genetic algorithm was proposed, and a large number of ground scenery spectra were produced by the simulator. Spectral similarity and the average spectral matching error of several typical ground scenery spectra were further analyzed. Spectral similarity of red bands, green bands, blue bands and near-infrared spectral band also was discussed. When the radiance of the target was 50 W x (m2 x sr)(-1), the average spectral matching error was less than 10% and spectral similarity was greater than 0.9, up to 0.983. Spectral similarity of red band, green band, blue band and near-infrared band (especially green band and near-infrared band) was less than that of full-band. Compared with blue band and red band, spectral similarity of green band and near-infrared band low-amplitude maximum can rearch 50%. Ground scenery spectrum radiation source can be used as radiometric calibration source for optical remote sensor, and calibration error, which is caused by objectives and calibration sources spectral mismatch, can be effectively reduced.

Clinical evaluation of cetuximab combined with an S-1 and oxaliplatin regimen for Chinese patients with advanced gastric cancer.

BACKGROUND: The prognosis of patients with advanced gastric cancer is poor. The goal of this study was to evaluate the efficacy and safety of combination therapy of cetuximab and S-1 combined with oxaliplatin (SOX) in Chinese patients with advanced gastric cancer. METHODS: For patients in the experimental group (cetuximab in combination with SOX (Ce-SOX), 30 patients), once-weekly cetuximab (400 mg/m2 at the first infusion then 250 mg/m2 every week) was administered. For patients in both the control (SOX alone, 26 patients) and experimental groups, oxaliplatin (100 mg/m2) was administered intravenously on day 1, while S-1 (80 mg/m2/day) was given orally twice daily for 14 days. The endpoints of this study included progression-free survival, response rate, and disease-control rate. RESULTS: There was no statistically significant difference in response rate between the Ce-SOX and SOX groups (54.8% versus 44%, P=0.225). The difference in disease-control rate was also statistically insignificant between the two groups (87.1% versus 76%, P=0.162). Median progression-free survival in the Ce-SOX group was significantly higher than that in the SOX group (12.8 versus 10.1 months, P=0.007). The median overall survival of the Ce-SOX group and SOX group was 14.0 and 12.2 months, respectively (P=0.043). The one-year survival rate for the Ce-SOX group was 57% compared to 40% in the SOX group. There was no statistical difference in the grade 3 or 4 adverse effects between the two groups. CONCLUSIONS: These findings suggest that the cetuximab combined with SOX regimen is feasible and shows promising efficacy with tolerable adverse effects in Chinese patients with advanced gastric cancer.

[The Application Study of Voriconazole and Its Metabolites Concentration Monitoring in Allogeneic Hematopoietic Stem Cell Transplantation Patients].

OBJECTIVE: To explore the application value of simultaneous monitoring of voriconazole (VRCZ) and voriconazole N-oxide (VNO) in efficacy and safety of VRCZ in the prevention and treatment of fungal infections in allogeneic hematopoietic stem cell transplantation (allo-HSCT) patients before engraftment (i.e., days +1 to +30 after transplantation). METHODS: The influencing factors of VRCZ, VNO concentration and MR (CVNO/CVRCZ) and the difference of VRCZ in the prevention and treatment of fungal infection and liver and kidney injury were analyzed. The receiver operating characteristic curve (ROC) was used to analyze the differences (the corresponding to the maximum of the Youden index on the curve was set as the cut-off value) to confirm the critical value. RESULTS: The factors affecting VRCZ concentration (CVRCZ), VNO concentration (CVNO) and MR were patient weight, VRCZ daily dose, and transplantation type (all P < 0.05). CVRCZ and CVNO in the effective group were higher than those in the ineffective group (P < 0.001), the opposite of MR (P < 0.001); the liver and renal injury group had lower MR than the normal group (P < 0.05). ROC showed that CVRCZ, C VNO and MR had important value in predicting VRCZ in the prevention and treatment of invasive fungal infections in allo-HSCT patients before engraftment, and their cutoff of concentrations were 0.95 µg/ml, 1.35 µg/ml and 1.645, respectively (AUC: 0.9677, 0.7634, 0.9564). CVRCZ and MR can assist in indicating liver ï¼»cutoff values: 0.65 µg/ml, 1.96 (AUC: 0.5971, 0.6663)ï¼½ and renal injury ï¼»cutoff values: 0.95 µg/ml, 1.705 (AUC: 0.6039, 0.6164)ï¼½. CONCLUSION: The great value of simultaneous monitoring of VRCZ, VNO and MR can predict in the efficacy and safety of VRCZ in allo-HSCT patients before engraftment. The prediction accuracy of CVRCZ was higher than that of MR, followed by that of CVNO. Increased CVRCZ and decreased MR increase the risk of liver and kidney injury.

Characteristics and literature review of ETV6::ABL1 fusion gene-positive acute myeloid leukemia.

OBJECTIVE: To describe the features of ETV6::ABL1 AML as well as the clinical treatment and outcomes. METHODS: Clinical data were collected from three patients diagnosed with ETV6::ABL1 AML at Hebei Yanda Lu Daopei Hospital and Beijing Lu Daopei Hospital. Their clinical and laboratory features were analyzed, and the treatment process and outcomes were described. Ten reported cases of ETV6::ABL1 AML from the literature were also included for analysis. RESULTS: The median age of the patients was 34 years, and 2 patients were male. No patient had a history of blood disorders before diagnosis. After relapse, they were referred to our hospital, where the ETV6::ABL1 gene was detected. Unfortunately, Patient 1 died rapidly after leukemia relapse due to severe infection. Patients 2 and 3 received salvage therapy with a dasatinib-containing regimen, followed by allo-HSCT, and are currently alive and disease-free. CONCLUSION: ETV6::ABL1 is a rare but recurrent genetic aberration in AML, and the combined use of fluorescence in situ hybridization and PCR can better identify this fusion gene. Patients carrying ETV6::ABL1 have a high relapse rate and a poor prognosis. TKIs are a reasonable treatment option for this group, and allo-HSCT may be curative.

[Measurement of relative spectral responsivity of photodetector by LED-based spectrum-tunable source].

A method of determining relative spectral responsivity of photodetector by LED-based spectrum-tunable integrating sphere source is put forward, and the measuring principle and algorithm are exhaustively described. In the course of calculation, the radiant transmission integral equation was changed into summation formula, and the degree of approximation between integral value and summation value is related to the selected wavelength interval. The differences between integral value and summation value in different wavelength intervals of Si photodiode and CCD were simulated and analyzed. The simulated results demonstrated that the relative differences between signal integral value and signal summation value of Si photodiode and CCD were below 0.2% in 10 nm interval, so 10 nm interval was an ideal choice. In the end, the factors affecting measurement accuracy were discussed and the solution suggestions were given. This method is easy in structure, and it avoids the measurement transmission errors of some instruments, such as monochromator.

Corn Silk Polysaccharides with Different Carboxyl Contents Reduce the Oxidative Damage of Renal Epithelial Cells by Inhibiting Endocytosis of Nano-calcium Oxalate Crystals.

OBJECTIVE: Renal epithelial cell injury and cell-crystal interaction are closely related to kidney stone formation. METHODS: This study aims to explore the inhibition of endocytosis of nano-sized calcium oxalate monohydrate (nano-COM) crystals and the cell protection of corn silk polysaccharides (CCSPs) with different carboxyl contents (3.92, 7.75, 12.90, and 16.38%). The nano-COM crystals protected or unprotected by CCSPs were co-cultured with human renal proximal tubular epithelial cells (HK-2), and then the changes in the endocytosis of nano-COM and cell biochemical indicators were detected. RESULTS: CCSPs could inhibit the endocytosis of nano-COM by HK-2 cells and reduce the accumulation of nano-COM in the cells. Under the protection of CCSPs, cell morphology is restored, intracellular superoxide dismutase levels are increased, lipid peroxidation product malondialdehyde release is decreased, and mitochondrial membrane potential and lysosomal integrity are increased. The release of Ca2+ ions in the cell, the level of cell autophagy, and the rate of cell apoptosis and necrosis are also reduced. CCSPs with higher carboxyl content have better cell protection abilities. CONCLUSION: CCSPs could inhibit the endocytosis of nano-COM crystals and reduce cell oxidative damage. CCSP3, with the highest carboxyl content, shows the best biological activity.

A global study for acute myeloid leukemia with RARG rearrangement.

Acute myeloid leukemia (AML) with retinoic acid receptor γ (RARG) rearrangement has clinical, morphologic, and immunophenotypic features similar to classic acute promyelocytic leukemia. However, AML with RARG rearrangement is insensitive to alltrans retinoic acid (ATRA) and arsenic trioxide (ATO) and carries a poor prognosis. We initiated a global cooperative study to define the clinicopathological features, genomic and transcriptomic landscape, and outcomes of AML with RARG rearrangements collected from 29 study groups/institutions worldwide. Thirty-four patients with AML with RARG rearrangements were identified. Bleeding or ecchymosis was present in 18 (54.5%) patients. Morphology diagnosed as M3 and M3v accounted for 73.5% and 26.5% of the cases, respectively. Immunophenotyping showed the following characteristics: positive for CD33, CD13, and MPO but negative for CD38, CD11b, CD34, and HLA-DR. Cytogenetics showed normal karyotype in 38% and t(11;12) in 26% of patients. The partner genes of RARG were diverse and included CPSF6, NUP98, HNRNPc, HNRNPm, PML, and NPM1. WT1- and NRAS/KRAS-mutations were common comutations. None of the 34 patients responded to ATRA and/or ATO. Death within 45 days from diagnosis occurred in 10 patients (∼29%). At the last follow-up, 23 patients had died, and the estimated 2-year cumulative incidence of relapse, event-free survival, and overall survival were 68.7%, 26.7%, and 33.5%, respectively. Unsupervised hierarchical clustering using RNA sequencing data from 201 patients with AML showed that 81.8% of the RARG fusion samples clustered together, suggesting a new molecular subtype. RARG rearrangement is a novel entity of AML that confers a poor prognosis. This study is registered with the Chinese Clinical Trial Registry (ChiCTR2200055810).

[Spectral calibration for the large aperture infrared radiometer].

The present paper introduced a spectral calibration method to calibrate a large aperture infrared radiation facility. We developed a radiometer which consisted of optical system, infrared detectors(cavity pyroelectric detector and HgCdTe detector 2 - 14 microm), fine mechanical modulator, lock in amplifier, signal processor, etc. At first, we analyzed the method on how to measure the spectral calibration of the large aperture infrared radiometer, and established the spectral calibration facility. Then, we tested the nonlinear response for the cavity pyroelectric detector and HgCdTe detector. Finally, we used the cavity pyroelectric detector to calibrate the relative spectral responsivity of HgCdTe detector at several wavelengths on the facility. Through the comparison of the two methods for measuring the relative spectral responsivity, the average of multiple measurements and comparative analysis of two methods were given. The uncertainty analysis of the whole system showed that the measurement uncertainty of the facility was better than 3.4%.

α-Glucosidase inhibitive diarylheptanoids from Ottelia acuminata var. acuminata, a traditional vegetable of Bai Nationality in Yunnan.

Diabetes is an urgent health issue characterized by ethnic and regional variations, and is inseparable from the different dietary habits. It is worthy to note that the incidence of diabetes in Bai nationality has been reported to be much lower than Han in China. As a daily vegetable of Bai, the phytochemical and antidiabetic study of Ottelia acuminata var. acuminata had not been carried out. In this study, 41 metabolites with diverse diarylheptanoid (six new ones, Otteacumienes A-F), flavone, sesquiterpenoid, coumarin, lignan, polyacetylene, and alkaloid skeletons were characterized from O. acuminata var. acuminata. Among them, the racemic nature of 3 was characterized by chiral resolution and calculated ECD methods. The biological study revealed diarylheptanoids showed significant α-glucosidase inhibitory activities with 5 as the most effective one (60-fold stronger than acarbose). Molecular docking studies indicated that these structures have different binding cavities with acarbose. This study demonstrated that O. acuminata var. acuminata might correlated with the low incidence diabetes of Bai and the diarylheptanoids may have potential therapeutic value for diabetes mellitus.

CYP2B6 gene single nucleotide polymorphisms and leukemia susceptibility.

CYP2B6 is a highly variable and polymorphic cytochrome P450 enzyme which plays a vital role in the degradation of some endogenous metabolites, xenobiotics, and harmful compounds. The 516G>T single nucleotide polymorphism (SNP) in exon 4 of CYP2B6 gene may change CYP2B6 enzyme activity and the gene expression in the liver. Carcinogens' failure to be degraded by CYP2B6 may cause DNA injury and cancer. Here, we aimed to evaluate the association between genotype or allele of CYP2B6 516G>T SNP and acute leukemia and myelodysplastic syndrome (MDS). We recruited 300 patients including 164 cases of acute myeloid leukemia (AML), 96 cases of acute lymphoblastic leukemia (ALL, including 17 cases of T-ALL and 79 cases of B-ALL), 40 cases of MDS, as well as 348 unrelated umbilical cord blood as the controls. Karyotype analysis and multiplex reverse transcription-polymerase chain reaction (RT-PCR) was performed to determine different recurrent genetic abnormalities in these cases. Genotype of CYP2B6 516G>T SNP was determined by allele-specific primers PCR, and confirmed by gel electrophoresis and sequencing. The GT and GT + TT genotype frequencies of c.516G>T SNP were higher in ALL (37.5% and 42.7%, respectively, P < 0.01), and AML (37.2% and 40.9%, respectively, P < 0.01) than in control (23.9% and 25.9%, respectively). In the subtypes of acute leukemias, the GT + TT genotype frequency was significantly higher in AML with recurrent genetic abnormalities (41.7%, p < 0.05), in AML-NOS (40.6%, p < 0.01), in acute monoblastic and monocytic leukemia (48.3%, p < 0.01), and in T-ALL (70.6%, p < 0.01) as compared with those in the controls. The frequency of CYP2B6 516 T allele was higher in AML (22.3%, p < 0.01) and ALL (24.0%, p < 0.01) compared with cord blood (13.9%). In different types of acute leukemias, CYP2B6 516 T allele frequency was significantly higher in AML with AML1-ETO (19.2%, p < 0.05), AML-NOS (22.7%, p < 0.01), acute monoblastic and monocytic leukemia (25.9%, p < 0.01), and T-ALL (38.2%, p < 0.01). MDS was unrelated to the genotype and allele frequencies of c.516G>T SNP in CYP2B6. T allele of CYP2B6 516G>T SNP may be one of the risk factors predisposing to the pathogenesis of a majority of ALL and AML, but has no relationship with B-ALL and leukemia with or without chromosome abnormalities.

[An analysis of etiological and genetic factors of a patient with familial hemophagocytic lymphohistiocytosis].

OBJECTIVE: To analyze the etiological factor and genetic feature of a familial hemophagocytic lymphohistiocytosis patient with PRF1 mutation (FHL2) with human herpesvirus 7 (HHV7) infection and its family constellation. METHODS: Clinical characteristics, laboratory examinations of a FHL2 case with HHV7 infection were reported. HHV1-HHV8 virus DNA was screened by PCR; NK cell function was analyzed by flow cytometry; PRF1 gene mutations were analyzed by PCR and direct sequencing, structure of mutant PRF1 proteins were analyzed using ExPasy and I-TASSER server and genetics pedigree were analyzed. RESULTS: The patient's HHV7 viral was detected positive with DNA copy number of 350/10(6) peripheral nucleated cells. Flow cytometry analysis showed decrease both in proportion of perforin positive NK cells and perforin protein expression. Genetic testing showed PRF1 biallelic heterozygote mutations (c.503G > A/p.S168N and c.1177T > C/p.C393R) and pedigree analysis showed they were inherited. The patient was then treated with antivirus therapy, dexamethasone and VP16 therapy, but only achieved partial response. The patient was then followed by human leukocyte antigen 10/10 allele identical non-consanguinity allogeneic hematopoietic stem cell transplantations (allo-HSCT) and soon the successful implantation of donor hematopoietic cells and persistent recovery was achieved. The patient was now surviving without recurrence for 9 months after allo-HSCT. CONCLUSIONS: FHL is prone to be misdiagnosed as lymphoma. Genetic analysis of related gene mutation and herpes simplex virus detection will help in early and accurate diagnosis. Allo-HSCT is a fundamental treatment of FHL.

[The study of gene mutations in unknown refractory viral infection and primary hemophagocytic lymphohistiocytosis].

OBJECTIVE: To study the type and corresponding clinical characteristics of primary hemophagocytic lymphohistiocytosis (HLH) associated immune gene mutations in the refractory virus infection or HLH of unknown causes. METHODS: From December 2009 to July 2010, the patients with refractory virus infection or HLH of unknown causes were screened for the primary HLH associated immune genes mutations by DNA sequence analysis, including PRF1, UNC13D, STX11, STXBP2, SH2D1A and XIAP. The clinical characteristics and outcomes were followed up. RESULTS: Totally 25 patients with refractory virus infection or HLH of unknown causes were investigated for the 6 genes and 13 cases were found carrying gene mutations, composing of 6 of PRF1 mutation, 3 of UNC13D, and each one of STX11, XIAP, SH2D1A and STXBP2, respectively. Among the 13 cases with gene mutations, 5 suffered from Epstein-Barr virus associated HLH (EBV-HLH), 1 human herpes virus 7 associated HLH (HHV7-HLH), 1 HLH without causes, 4 chronic activated EB virus infection (CAEBV) with 1 progressing to Hodgkin's lymphoma carrying abnormal chromosome of t(15;17) (q22;q25) and hyperdiploid, 2 EBV associated lymphoma. Among the other 12 patients without gene mutation, 4 suffered from EBV-HLH with 1 progressing to peripheral T lymphoma, 8 suffered from CAEBV. CONCLUSIONS: Primary HLH associated immune gene mutations are critical causes of refractory virus infection of unknown causes, most patients manifest as HLH, some cases appear in CAEBV and EBV associated lymphoma. DNA sequence analysis is helpful to early diagnosis and correct decision-making for treatment.

Computational Modeling of Catheter-based Radiofrequency Renal Denervation with Patient-specific Model.

Renal sympathetic denervation (RDN) is an effective approach for uncontrolled hypertension. Although several studies have compared the ablation characteristics at various locations, there is no direct comparative study on the effect of ablation in main and branch renal artery (RAs) and different electrode materials. The study aims to investigate the effect of different electrode materials (copper, gold, and platinum) and positions (proximal, middle, or distal site) on ablation. A 3D patient-specific renal artery model and a unipolar model (470 kHz) were constructed to mimic RDN. Two therapeutic strategies, including main (site 1 and 2) and branch (site 3) ablations were simulated with three electrode materials. The finite element method was used to calculate the coupled electric-thermal-flow field. Maximum lesion depth, width, area, and lesion angle were analyzed. The results showed that the difference in lesion width and depth was no mere than 0.5 mm, and the maximum difference value in lesion area is 0.683 mm2 among three electrode materials. The lesion angle of proximal site 1 versus middle site 2 was 58.39 ° and 52.23 °, but the difference between distal site 3 and site 1, or site 2 was 29.19 ° and 35.35 ° respectively. There is no significant difference in the use of the three electrode materials, and ablation at the distal site of the artery is more effective.Clinical Relevance-This provides a reference for the selection of RF electrode materials and ablation locations.

Therapeutic Applications of Functional Nanomaterials for Prostatitis.

Prostatitis is a common disease in adult males, with characteristics of a poor treatment response and easy recurrence, which seriously affects the patient's quality of life. The prostate is located deep in the pelvic cavity, and thus a traditional infusion or other treatment methods are unable to easily act directly on the prostate, leading to poor therapeutic effects. Therefore, the development of new diagnostic and treatment strategies has become a research hotspot in the field of prostatitis treatment. In recent years, nanomaterials have been widely used in the diagnosis and treatment of various infectious diseases. Nanotechnology is a promising tool for 1) the accurate diagnosis of diseases; 2) improving the targeting of drug delivery systems; 3) intelligent, controlled drug release; and 4) multimode collaborative treatment, which is expected to be applied in the diagnosis and treatment of prostatitis. Nanotechnology is attracting attention in the diagnosis, prevention and treatment of prostatitis. However, as a new research area, systematic reviews on the application of nanomaterials in the diagnosis and treatment of prostatitis are still lacking. In this mini-review, we will highlight the treatment approaches for and challenges associated with prostatitis and describe the advantages of functional nanoparticles in improving treatment effectiveness and overcoming side effects.