Observation of the Therapeutic Effect of Hydrogel Combined with Alginate Dressings for a Patient with Grade 4 Acute Radiation Dermatitis: A Case Report.

ABSTRACT: In this case report, the authors summarize their experience of using hydrogel combined with alginate dressings in the wound care of a patient with grade 4 acute radiation dermatitis. With the combination of hydrogel and alginate dressings, the authors achieved autolytic debridement of the wound and created a moist healing environment to facilitate wound closure. Hydrogel helps the dressing adhere better to the wound bed, ensuring that it does not easily detach during the wound healing process. It also eliminates the need for traditional adhesive tapes for fixation, thus avoiding damage to the fragile skin in the radiation field.The wound gradually decreased in size from an area of 10 × 12 cm, and exudate decreased continuously. The wound completely healed in 20 days with a total of 17 dressing changes. As the wound gradually healed, the patient's psychological burden decreased and comfort level increased. The patient expressed satisfaction and hope for the gradual healing of the wound.Thus, the treatment of severe acute radiation dermatitis with hydrogel combined with alginate dressings yields remarkable results, aligning the noninvasive, low-adhesive, absorbent, conformable, and comfortable attributes of optimized wound care. This experience provides a practical foundation for wound management in acute radiation dermatitis and supports clinical application and promotion of the approach.

Amniotic fluid metabolomic and lipidomic alterations associated with hemoglobin Bart's diseases.

INTRODUCTION: α-Thalassemia is the most common inherited disease in southern China. The severest form is hemoglobin (Hb) Bart's disease, in which the affected fetuses almost always die in utero or shortly after birth, and the mothers are at high risk for severe morbidity. OBJECTIVE: To investigate the changes in all metabolites in fetuses with Hb Bart's disease and to characterize the metabolomic and lipidomic biomarkers in the development of Hb Bart's fetuses. METHODS: Amniotic fluid (AF) specimens were selected from 34 pregnant women who underwent interventional prenatal diagnosis from June 2017 to June 2018. Gap-PCR analysis was used to diagnose Hb Bart's disease, and untargeted metabolomic and lipidomic analyses were performed. RESULTS: By analyzing AF samples, 935 differential metabolites were selected between Hb Bart's and control fetuses. The metabolites with significant changes mainly involved D-glutamine and D-glutamate metabolism, histidine metabolism, arginine metabolism, beta-alanine metabolism and alanine, aspartate and glutamate metabolism. Further lipidomics analysis revealed 132 differential lipids, mainly involved phosphatidylcholine and triglyceride metabolism. Through the characterized metabolites in AF, a schematic model of Hb Bart's disease was established. CONCLUSION: Glutamate and glutathione metabolism, aspartate metabolism, urea metabolism and triglyceride metabolism were significantly changed in the Hb Bart's group compared to the control group. The characterized biomarkers were mainly involved in oxidative stress reaction, iron overload and liver dysfunction. This finding may help improve the treatment options for α-thalassemia as well as diagnosing phenotype of patients.

Further Improving Image Quality of Cardiovascular Computed Tomography Angiography for Children With High Heart Rates Using Second-Generation Motion Correction Algorithm.

BACKGROUND: The state-of-art motion correction algorithm is inadequate for correcting motion artifacts in coronary arteries in cardiovascular computed tomography angiography (CCTA) for children with high heart rates, and even less effective for heart structures beyond coronary arteries. PURPOSE: This study aimed to evaluate the effectiveness of a second-generation, whole-heart motion correction algorithm in improving the heart image quality of CCTA for children with high heart rates. MATERIALS AND METHODS: Forty-two consecutive symptomatic cardiac patients with high heart rates (122.6 ± 18.8 beats/min) were enrolled. All patients underwent CCTA on a 256-row CT using a prospective electrocardiogram-triggered single-beat protocol. Images were reconstructed using a standard algorithm (STD), state-of-the-art first-generation coronary artery motion correction algorithm (MC1), and second-generation, whole-heart motion correction algorithm (MC2). The image quality of the origin of left coronary, right coronary, aortic valve, pulmonary valve, mitral valve, tricuspid valve, aorta root, pulmonary artery root, ventricular septum (VS), and atrial septum (AS) was assessed by 2 experienced radiologists using a 4-point scale (1, nondiagnostic; 2, detectable; 3, measurable; and 4, excellent); nonparametric test was used to analyze and compare the differences among 3 groups; and post hoc multiple comparisons were used between different methods. RESULTS: There were group differences for cardiac structures except VS and AS, with MC2 having the best image quality and STD having the worst image quality. Post hoc multiple comparisons showed that MC2 was better than MC1 and STD in all structures except VS and AS where all 3 algorithms performed equally, whereas MC1 was better than STD only in the origin of left coronary, right coronary, and mitral valve. CONCLUSIONS: A second-generation, whole-heart motion correction algorithm further significantly improves cardiac image quality beyond the coronaries in CCTA for pediatric patients with high heart rates.

Left atrial appendage aneurysm in pediatrics.

Left atrial appendage aneurysm (LAAA) is a rare cardiac anomaly with potentially life-threatening complications of atrial tachyarrhythmias and systemic thromboembolism. It is often diagnosed incidentally and rarely during childhood. Echocardiography is considered the primary method of LAAA diagnosis; in particular, the subxiphoid view is more useful in pediatrics. Surgical intervention and drug management are recommended to prevent potentially lethal complications. Herein, we report five cases of patients with LAAA during infancy and childhood, caused by both congenital and acquired conditions. One patient underwent surgical resection through left lateral thoracotomy without cardiopulmonary bypass and another patient underwent drug management.

Diagnosis of double-chambered left ventricle using echocardiography.

Double-chambered left ventricle (DCLV) is a particularly rare congenital cardiovascular malformation that is difficult to diagnose. It is characterized by the subdivision of the left ventricle into two chambers by an abnormal septum or muscle band. Here, we report 12 patients with DCLV. Differential diagnoses of DCLV include four other cardiac diseases, diverticulum, aneurysm, hypertrophic cardiomyopathy, and left ventricular noncompaction. Echocardiography plays an important role in the diagnosis of this rare condition and in differentiating it from other diseases.

Development and Teaching Application of Interactive Virtual Algorithm Animation of C Language Program.

In today's world, almost every domain has certain and mandatory requirements to understand at least one of the programming languages which is defined as a way of interaction with a computer to resolve real world problems or more specifically for the implementation of algorithms. Language programming is a course with strong theory and practice. In view of the fact that C language beginners in colleges and universities generally report that it is difficult to learn well due to various reasons. Therefore, in this paper, we have discussed the development and teaching of interactive virtual animation of C language programs. The proposed approach relies on a typical recursive algorithm case to analyze the teaching strategy of virtual algorithm animation brought into the classroom, the application in the algorithm teaching of C language and the teaching strategy in improving students' understanding of abstract knowledge using computer C language program interactive virtual animation development and implementation of the teaching system is the research content. According to the basic flow of the interactive virtual algorithm of the C language program, a reasonable system structure design is carried out.

3D Animation Automatic Generation System Design Based on Deep Learning.

In the field of 3D animation design and generation, the expression generation method of animation is not obvious due to the lack of image details, which leads to the lack of realism of the generated animation expressions. In order to solve this problem, a deep learning-based animation character expression generation method is proposed. The method, based on the real facial expression images, uses improved deep learning to design cascade classifiers, extracts facial expression feature images from real images, softens image edges, and enhances feature details. The content and style of images are unified, the loss function is designed from the content constraints and style constraints, the judgment network is optimized, and the feature information is fused under the constraints of the loss function to generate the facial expressions of animated characters. The experimental results show that the design based on the feature point location of the improved deep learning expression generation method is accurate, the Pearson correlation coefficient between the input image and the generated image is high, the root mean square error is small, and the realism of the generated facial expression is enhanced.

Synthesis of hybrid Au-Ag2S-Cu2-xS nanocrystals with disparate interfacial features.

Hybrid nanocrystals (NCs) with multiple components and junctions have attracted considerable attention due to their promising synergistic properties. In particular, great attention has been paid to the manipulation of buried multijunction heterointerfaces because they are closely related to the surface energy and carrier transfer of NCs. However, heterointerfaced NCs are usually constructed by sequential step-by-step pathways, and buried interfaces can only be formed along a given direction, resulting in the one and only spatial orientation of multiple interfaces. In this work, we demonstrate two types of Au-Ag2S-Cu2-xS NCs with disparate interfacial features. Specifically, the first type (Type I) is prepared through a routine two-step method and shows that Au domain close to the Ag2S-Cu2-xS interface; another type (Type II) is achieved by a facile one-pot synthesis procedure and contains Au domain with an interphase only with the Ag2S domain, far from the Cu2-xS domain. More importantly, type II NCs could not be formed through other traditional strategies and an underlying mechanism of formation is developed by monitoring the evolution process. Au@Ag core-shell NCs, metastable Au@Ag2S NCs and Janus Au-Ag2S NCs are formed successively before the Cu2-xS domain appears. We speculate that the Au@Ag2S intermediate plays an essential role in building the final complex nanostructure. We expect that such a simple and facile one-pot method will be used to fabricate additional asymmetric multicomponent NCs with distinctive interfacial features and promising potential applications.

Kommerell diverticulum, vascular ring, and aberrant left subclavian artery: LSCA translocation or aortopexy.

BACKGROUND/PURPOSE: Kommerell diverticulum (KD) in children with right aortic arch and aberrant left subclavian artery can be treated surgically via left subclavian artery (LSCA) translocation or aortopexy. These procedures remain controversial. We compared the outcomes of both procedures. METHODS: This retrospective study included 48 patients who underwent LSCA translocation (n = 26) or aortopexy (n = 22). Lateral thoracotomy and sternotomy were performed in 38 and 10 patients with severe intracardiac malformations, respectively. RESULTS: The median age of the aortopexy group was 10 months, median follow-up was 14 months, and mean length of hospitalization was 11.41 ± 6.8 days. The median age of the LSCA translocation group was 12 months, median follow-up was 22 months, and mean length of hospitalization was 14.96 ± 7.74 days. Two patients (LSCA translocation group) required secondary intubations and none suffered from recurrent laryngeal nerve injury or complications related to LSCA translocation. Breathing and swallowing symptoms were relieved in all patients. No additional thoracotomies due to respiratory symptoms were required. CONCLUSIONS: These two procedures relieve the pressure on the trachea and esophagus with similar short-term outcomes. The long-term outcomes are unknown. LSCA translocation may be the best strategy to prevent symptom recurrence and late complications in these patients. LEVEL OF EVIDENCE: Level III.

Performance evaluation of using shorter contrast injection and 70 kVp with deep learning image reconstruction for reduced contrast medium dose and radiation dose in coronary CT angiography for children: a pilot study.

BACKGROUND: Iterative reconstruction algorithms are often used to reduce image noise in low-dose coronary computed tomography angiography (CCTA) but encounter limitations. The newly introduced deep learning image reconstruction (DLIR) algorithm may provide new opportunities. We assessed the image quality and diagnostic performance of DLIR in low radiation dose and contrast medium dose CCTA of pediatric patients with 70 kVp and a shortened injection protocol. METHODS: This was a prospective study. A total of 27 consecutive arrhythmic pediatric patients were enrolled in the study group and underwent CCTA using a prospective ECG-triggered single-beat protocol: tube voltage 70 kVp, automatic tube current modulation for a noise index (NI) of 22, and contrast dose of 0.4-0.6 mL/kg. Images were reconstructed with DLIR. They were compared with 27 matched patients in the control group scanned with 80 kVp, a lower NI setting (NI =19), and a higher contrast dose (0.8-1.2 mL/kg). The images in the control group were reconstructed using the adaptive statistical iterative reconstruction (ASIR-V) algorithm. The image contrast, image quality, and diagnostic confidence were assessed by 2 experienced radiologists using a 5-point scale (1: nondiagnostic and 5: excellent). The CT value and standard deviation of the aorta and perivascular tissue were measured, and the contrast-to-noise ratio (CNR) for the aorta was calculated. The contrast medium and radiation doses were compared. RESULTS: The study and control groups had similar image contrast scores (4.75±0.57 vs. 4.78±0.42), image quality scores (3.67±0.47 vs. 3.44±0.51), and diagnostic confidence (4.74±0.44 vs. 4.74±0.45) (all P>0.05). There was an adequate enhancement in the aorta (614.74±127.73 vs. 705.89±111.20 HU) and similar CNR (20.34±4.64 vs. 20.99±4.14) in both groups. The image noise of the study group was lower in the aorta (30.61±3.88 vs. 34.77±3.49) and similar in perivascular tissue (27.66±6.24 vs. 27.55±3.33) compared with the control group. The study group reduced the total contrast medium dose by 53% to 15.07±3.68 mL and radiation dose by 36% to 0.57±0.31 mSv. CONCLUSIONS: The DLIR algorithm in CCTA for children using 70 kVp tube voltage with a shortened contrast medium injection protocol maintains image quality and diagnostic confidence while significantly reducing contrast medium dose and radiation dose compared with the use of the conventional CCTA protocol.

Clinical efficacy of integral theory-guided laparoscopic integral pelvic floor/ligament repair in the treatment of internal rectal prolapse in females.

BACKGROUND: Internal rectal prolapse (IRP) is one of the most common causes of obstructive constipation. The incidence of IRP in women is approximately three times that in men. IRP is mainly treated by surgery, which can be divided into two categories: Abdominal procedures and perineal procedures. This study offers a better procedure for the treatment of IRP. AIM: To compare the clinical efficacy of laparoscopic integral pelvic floor/ligament repair (IPFLR) combined with a procedure for prolapse and hemorrhoids (PPH) and the laparoscopic IPFLR alone in the treatment of IRP in women. METHODS: This study collected the clinical data of 130 female patients with IRP who underwent surgery from January 2012 to October 2014. The patients were divided into groups A and B. Group A had 63 patients who underwent laparoscopic IPFLR alone, and group B had 67 patients who underwent the laparoscopic IPFLR combined with PPH. The degree of internal rectal prolapse (DIRP), Wexner constipation scale (WCS) score, Wexner incontinence scale (WIS) score, and Gastrointestinal Quality of Life Index (GIQLI) score were compared between groups and within groups before surgery and 6 mo and 2 years after surgery. RESULTS: All laparoscopic surgeries were successful. The general information, number of bowel movements before surgery, DIRP, GIQLI score, WIS score, and WCS score before surgery were not significantly different between the two groups (all P > 0.05). The WCS score, WIS score, GIQLI score, and DIRP in each group 6 mo, and 2 years after surgery were significantly better than before surgery (P < 0.001). In group A, the DIRP and WCS score gradually improved from 6 mo to 2 years after surgery (P < 0.001), and the GIQLI score progressively improved from 6 mo to 2 years after surgery (P < 0.05). In group B, the DIRP, WCS score and WIS score significantly improved from 6 mo to 2 years after surgery (P < 0.05), and the GIQLI score 2 years after surgery was significantly higher than that 6 mo after surgery (P < 0.05). The WCS score, WIS score, GIQLI score, and DIRP of group B were significantly better than those of group A 6 mo and 2 years after surgery (all P < 0.001, Bonferroni) except DIRP at 2 years after surgery. There was a significant difference in the recurrence rate of IRP between the two groups 6 mo after surgery (P = 0.011). There was no significant difference in postoperative grade I-III complications between the two groups (P = 0.822). CONCLUSION: Integral theory-guided laparoscopic IPFLR combined with PPH has a higher cure rate and a better clinical efficacy than laparoscopic IPFLR alone.

Subtotal colonic bypass plus colostomy with antiperistaltic cecoproctostomy for the treatment of slow transit constipation in an aged population: A retrospective control study.

AIM: To compare the efficacy, improved quality of life, and prognosis in patients undergoing either subtotal colonic bypass with antiperistaltic cecoproctostomy (SCBAC) or subtotal colonic bypass plus colostomy with antiperistaltic cecoproctostomy (SCBCAC) for the treatment of slow transit constipation. METHODS: Between October 2010 and October 2014, aged patients with slow transit constipation who were hospitalized and underwent laparoscopic surgery in our institute were divided into two groups: the bypass group, 15 patients underwent SCBAC, and the bypass plus colostomy group, 14 patients underwent SCBCAC. The following preoperative and postoperative clinical data were collected: gender, age, body mass index, operative time, first flatus time, length of hospital stay, bowel movements (BMs), Wexner fecal incontinence scale, Wexner constipation scale (WCS), gastrointestinal quality of life index (GIQLI), numerical rating scale for pain intensity (NRS), abdominal bloating score (ABS), and Clavien-Dindo classification of surgical complications (CD) before surgery and at 3, 6, 12, and 24 mo after surgery. RESULTS: All patients successfully underwent laparoscopic surgery without open surgery conversion or surgery-related death. The operative time and blood loss were significantly less in the bypass group than in the bypass plus colostomy group (P = 0.007). No significant differences were observed in first flatus time, length of hospital stay, or complications with CD > 1 between the two groups. No patients had fecal incontinence after surgery. At 3, 6, and 12 mo after surgery, the number of BMs was significantly less in the bypass plus colostomy group than in the bypass group. The parameters at 3, 6, 12, and 24 mo after surgery in both groups significantly improved compared with the preoperative conditions (P < 0.05), except NRS at 3, 6 mo after surgery in both groups, ABS at 12, 24 mo after surgery and NRS at 12, 24 mo after surgery in the bypass group. WCS, GIQLI, NRS, and ABS significantly improved in the bypass plus colostomy group compared with the bypass group at 3, 6, 12, and 24 mo after surgery (P < 0.05) except WCS, NRS at 3, 6 mo after surgery and ABS at 3 mo after surgery. At 1 year after surgery, a barium enema examination showed that the emptying time was significantly better in the bypass plus colostomy group than in the bypass group (P = 0.007). CONCLUSION: Laparoscopic SCBCAC is an effective and safe procedure for the treatment of slow transit constipation in an aged population and can significantly improve the prognosis. Its clinical efficacy is more favorable compared with that of SCBAC. Laparoscopic SCBCAC is a better procedure for the treatment of slow transit constipation in an aged population.

An Overexpressed Q Allele Leads to Increased Spike Density and Improved Processing Quality in Common Wheat (Triticum aestivum).

Spike density and processing quality are important traits in modern wheat production and are controlled by multiple gene loci. The associated genes have been intensively studied and new discoveries have been constantly reported during the past few decades. However, no gene playing a significant role in the development of these two traits has been identified. In the current study, a common wheat mutant with extremely compact spikes and good processing quality was isolated and characterized. A new allele (Qc1 ) of the Q gene (an important domestication gene) responsible for the mutant phenotype was cloned, and the molecular mechanism for the mutant phenotype was studied. Results revealed that Qc1 originated from a point mutation that interferes with the miRNA172-directed cleavage of Q transcripts, leading to its overexpression. It also reduces the longitudinal cell size of rachises, resulting in an increased spike density. Furthermore, Qc1 increases the number of vascular bundles, which suggests a higher efficiency in the transportation of assimilates in the spikes of the mutant than that of wild type. This accounts for the improved processing quality. The effects of Qc1 on spike density and wheat processing quality were confirmed by analyzing nine common wheat mutants possessing four different Qc alleles. These results deepen our understanding of the key roles of Q gene, and provide new insights for the potential application of Qc alleles in wheat quality breeding.

Mechanisms of wheat (Triticum aestivum) grain storage proteins in response to nitrogen application and its impacts on processing quality.

Basis for the effects of nitrogen (N) on wheat grain storage proteins (GSPs) and on the establishment of processing quality are far from clear. The response of GSPs and processing quality parameters to four N levels of four common wheat cultivars were investigated at two sites over two growing seasons. Except gluten index (GI), processing quality parameters as well as GSPs quantities were remarkably improved by increasing N level. N level explained 4.2~59.2% and 10.4~80.0% variability in GSPs fractions and processing quality parameters, respectively. The amount of N remobilized from vegetative organs except spike was significantly increased when enhancing N application. GSPs fractions and processing quality parameters except GI were only highly and positively correlated with the amount of N remobilized from stem with sheath. N reassimilation in grain was remarkably strengthened by the elevated activity and expression level of glutamine synthetase. Transcriptome analysis showed the molecular mechanism of seeds in response to N levels during 10~35 days post anthesis. Collectively, we provided comprehensive understanding of N-responding mechanisms with respect to wheat processing quality from N source to GSPs biosynthesis at the agronomic, physiological and molecular levels, and screened candidate genes for quality breeding.

Linoleic acid isomerase gene FgLAI12 affects sensitivity to salicylic acid, mycelial growth and virulence of Fusarium graminearum.

Fusarium graminearum is the major causal agent of fusarium head blight in wheat, a serious disease worldwide. Linoleic acid isomerase (LAI) catalyses the transformation of linoleic acid (LA) to conjugated linoleic acid (CLA), which is beneficial for human health. We characterised a cis-12 LAI gene of F. graminearum (FGSG_02668; FgLAI12), which was downregulated by salicylic acid (SA), a plant defence hormone. Disruption of FgLAI12 in F. graminearum resulted in decreased accumulation of cis-9,trans-11 CLA, enhanced sensitivity to SA, and increased accumulation of LA and SA in wheat spikes during infection. In addition, mycelial growth, accumulation of deoxynivalenol, and pathogenicity in wheat spikes were reduced. Re-introduction of a functional FgLAI12 gene into ΔFgLAI12 recovered the wild-type phenotype. Fluorescent microscopic analysis showed that FgLAI12 protein was usually expressed in the septa zone of conidia and the vacuole of hyphae, but was expressed in the cell membrane of hyphae in response to exogenous LA, which may be an element of LA metabolism during infection by F. graminearum. The cis-12 LAI enzyme encoded by FgLAI12 is critical for fungal response to SA, mycelial growth and virulence in wheat. The gene FgLAI12 is potentially valuable for biotechnological synthesis of cis-9,trans-11 CLA.

[Influence of length of preserved ileocecum on the efficacy of laparoscopic subtotal colectomy antiperistaltic cecorectal anastomosis in the treatment of slow transit constipation].

OBJECTIVE: To investigate the influence of length of preserved ileocecum on the efficacy of laparoscopic subtotal colectomy antiperistaltic cecorectal anastomosis (LSCACRA) in treating slow transit constipation (STC). METHODS: Clinical data of 81 STC patients who received LSCACRA between April 2007 And December 2011 in the 150th Center Hospital of PLA were continuously collected. Patients were divided into two groups: 10 cm to 15 cm ascending colon preserved above ileocecal junction(10-15 cm group, n=41), and 2 cm to 3 cm ascending colon preserved above ileocecal junction (2-3 cm group, n=40). The Wexner constipation scale (WCS), Wexner incontinence scale(WIS), gastrointestinal quality of life index(GIQLI), abdominal pain intensity scale(NRS), abdominal pain frequency scale and abdominal bloating frequency scale in the two groups were determined and compared before and 6, 12, 24 months after operation. RESULTS: No postoperative incontinence was found in all the patients. There were no significant differences in evacuation frequency between two groups at 6th and 12th month after surgery (all P>0.05). Two years after operation, barium enema emptying time examination revealed 2-3 cm group was (17.7±9.5) h, which was remarkably shorter than (21.2±20.7) h in 10-15 cm group (P=0.011). The WCS, GIQLI, NRS and abdominal pain frequency scale of two groups were improved obviously at 6th, 12th and 24th month after surgery (all P<0.01). Above parameters in 2-3 cm group were superior to 10-15 cm group (all P<0.01), but abdominal bloating frequency scale was not significantly different between the two groups (P>0.05). As compared with before operation, NRS in 2-3 cm group 6, 12, 24 months after operation reduced remarkably (all P<0.01), but did not improve obviously in 10-15 cm group (P>0.05). CONCLUSION: The shorter length of ascending colon preserved above ileocecal junction can improve the efficacy of LSCACRA in the treatment of STC and the prognosis of patients. Two to three cm length of ascending colon preserved above the ileocecal junction should be recommended.