Prognostic significance and value of further classification of lymphovascular invasion in invasive breast cancer: a retrospective observational study.

PURPOSE: To investigate the prognostic significance of lymphovascular invasion in invasive breast cancer and the value of using specific vascular endothelial markers to further classify lymphovascular invasion. METHODS: We collected 2124 patients with invasive breast cancer who were hospitalized at the First Hospital of Dalian Medical University from 2012 to 2020. Statistical methods were used to investigate the relationship between lymphovascular invasion and clinicopathological characteristics of breast cancer, and the correlation between lymphovascular invasion on overall survival (OS) and disease-free survival (DFS) of various categories of breast cancers. Immunohistochemical staining of breast cancer samples containing lymphovascular invasion using specific vascular endothelial markers D2-40 and CD34 was used to classify lymphovascular invasion and to investigate the relationship between lymphovascular invasion and breast cancer progression. RESULTS: There was a high correlation between lymphovascular invasion and T stage, N stage and nerve invasion. Survival analyses showed that patients with lymphovascular invasion, especially luminal B, triple-negative, and Her-2 overexpression breast cancer patients, had poorer OS and DFS prognosis, and that lymphovascular invasion was an independent prognostic factor affecting OS and DFS in breast cancer. The immunohistochemical staining results showed that positive D2-40 staining of lymphovascular invasion was linked to the N stage and localized recurrence of breast cancer. CONCLUSION: Lymphovascular invasion is associated with aggressive clinicopathological features and is an independent poor prognostic factor in invasive breast cancer. Breast cancer localized recurrence rate and lymph node metastases are influenced by lymphatic vessel invasion. Immunohistochemical techniques should be added to the routine diagnosis of lymphovascular invasion.

Quantitative prediction of AFB1 in various types of edible oil based on absorption, scattering and fluorescence signals at dual wavelengths.

This study aims to address the challenge of matrix interference of various types of edible oils on intrinsic fluorescence of aflatoxin B1 (AFB1) by developing a novel solution. Considering the fluorescence internal filtering effect, the absorption (µa) and reduced scattering (µ's) coefficients at dual wavelengths (excitation: 375 nm, emission: 450 nm) were obtained by using integrating sphere technique, and were used to improve the quantitative prediction results for AFB1 contents in six different kinds of edible oils. A research process of "Monte Carlo (MC) simulation - phantom verification - actual sample validation" was conducted. The MC simulation was used to determine interference rule and correction parameters for fluorescence, the results indicated that the escaped fluorescence flux nonlinearly decreased with the µa, µ's at emission wavelength (µa,em, µ's,em) and µa at excitation wavelength (µa,ex), however increased with the µ's at excitation wavelength (µ's,ex). And the required optical parameters to eliminate the interference of matrix on fluorescence intensity are: effective attenuation coefficients at excitation and emission wavelengths (µeff,ex, µeff,em) and µ's,ex. Phantom verification was conducted to explore the feasibility of fluorescence correction based on the identified parameters by MC simulation, and determine the optimal machine learning method. The modelling results showed that least squares support vector regression (LSSVR) model could reach the best performance. Three kinds of edible oil (peanut, rapeseed, corn), each with two brands were used to prepare oil samples with different AFB1 contamination. The LSSVR model for AFB1 based on µeff,ex, µeff,em, µ's,ex and fluorescence intensity at 450 nm was calibrated, both correlation coefficients for calibration (Rc) and the validation (Rv) sets could reach 1.000, root mean square errors for calibration (RMSEC) and the validation (RMSEV) sets were as low as 0.038 and 0.099 respectively. This study proposed a novel method which is based solely on the absorption, scattering, and fluorescence characteristics at excitation and emission wavelengths to achieve accurate prediction of AFB1 content in different types of vegetable oils.

A novel method for determination of peroxide value and acid value of extra-virgin olive oil based on fluorescence internal filtering effect correction.

Peroxide value (PV) and acid value (AV) are widely used indicators for evaluating oxidation degree of olive oils. Fluorescence spectroscopy has been extensively studied on the detection of oil oxidation, however, the detection accuracy is limited due to internal filtering effect (IFE). Due to the primary and secondary IFE, at least two wavelengths of absorption information are required. Least squares support vector regression (LSSVR) models for PV and AV were established based on two absorption coefficients (µa) at 375 nm and emission wavelength and one fluorescence intensity at corresponding wavelength. The regression results proved that the model based on 375 and 475 nm could reach the best performance, with the highest correlation coefficient for prediction (rp) of 0.889 and 0.960 for PV and AV respectively. Finally, the explicit formulations for PV and AV were determined by nonlinear least squares fitting, and the rp could reach above 0.94 for two indicators.

Salvage treatment of acute respiratory failure after autogenous tissue flap transplantation for chronic empyema with chest wall sinus: a case report and literature review.

BACKGROUND: Chronic empyema with chest wall sinus is a difficult and complex disease caused by multiple causative factors. It is difficult to control local infection due to its possible combination of bronchopleural fistula (BPF) and residual bone.The relevant literature emphasizes some risk factors for empyema progression after pneumonectomy, while the correlation between empyema and BPF after pneumonectomy increases mortality by infecting the remaining lungs. After pneumonectomy, the lung function of the contralateral side is particularly important. CASE PRESENTATION: This paper reports a 62-year-old male patient who underwent right pneumonectomy for squamous cell carcinoma of the lung 12 years ago and began to develop empyema with anterior chest wall sinus 3 years ago. After admission, chest computed tomography (CT) showed right pleural effusion and formation of chest wall sinus. According to his clinical symptoms and imaging examination, he was diagnosed as chronic empyema with chest wall sinus.Due to the huge residual cavity of the patient,the clinical effect of using free vastus lateralis myocutaneous flap combined with pedicled pectoralis major muscle flap to fill the abscess cavity was satisfactory,but acute respiratory failure occurred due to left lung aspiration pneumonia after operation. CONCLUSIONS: After a series of treatment measures such as tracheal cannula, tracheotomy, anti-infection, maintenance of circulatory stability, and rehabilitation training, the patient was ultimately rescued and cured. Postoperative follow-up showed that the muscle flaps survived and empyema was eliminated.

Long non-coding RNA Homeobox D gene cluster antisense growth-associated long noncoding RNA/microRNA-182-5p/Homeobox protein A10 alleviates postmenopausal osteoporosis via accelerating osteoblast differentiation of bone marrow mesenchymal stem cells.

BACKGROUND: Studies have illuminated that long non-coding RNA (lncRNA) influences bone cell differentiation and formation. Nevertheless, whether lncRNA Homeobox D gene cluster antisense growth-associated long noncoding RNA (HAGLR) was implicated in postmenopausal osteoporosis (PMOP) was yet uncertain. PURPOSE: The research was to explore HAGLR's role in the osteogenic differentiation (OD) process of bone marrow mesenchymal stem cells (BMSCs). METHODS: BMSCs were isolated from mouse bone marrow tissues and identified by electron microscope and flow cytometry. HAGLR, microRNA (miR)-182-5p, and homeobox protein A10 (Hoxa10) levels in BMSCs were detected. Mouse BMSC OD process was induced, and calcium deposition and alkaline phosphatase content were analyzed, as well as expressions of runt-related transcription factor 2, osteopontin, and osteocalcin, and cell apoptosis. Bilateral ovaries were resected from mice to construct the ovariectomized model and bone mineral density, maximum bending stress, maximum load, and elastic modulus of the femur were tested, and the femur was histopathologically evaluated. Chondrocyte apoptosis in the articular cartilage of mice was analyzed. Analysis of the interaction of HAGLR, miR-182-5p with Hoxa10 was conducted. RESULTS: HAGLR and Hoxa10 were down-regulated and miR-182-5p was elevated in PMOP patients. During the BMSC OD process, HAGLR and Hoxa10 levels were suppressed, while miR-182-5p was elevated. Promotion of HAGLR or suppression of miR-182-5p accelerated OD of BMSCs. Inhibition of miR-182-5p reversed the inhibitory effect of HAGLR on BMSC OD. In in vivo experiments, up-regulating HAGLR alleviated PMOP, while silencing Hoxa10 reversed the effects of upregulating HAGLR. HAGLR performed as a sponge for miR-182-5p, while miR-182-5p targeted Hoxa10. CONCLUSION: In general, HAGLR boosted the OD process of BMSCs and relieved PMOP via the miR-182-5p/Hoxa10 axis. These data preliminarily reveal the key role of HAGLR in PMOP, and the research results have a certain reference for the treatment of PMOP.

Identification of aged-rice adulteration based on near-infrared spectroscopy combined with partial least squares regression and characteristic wavelength variables.

The long-term storage of rice will inevitably be involved in the deterioration of edible quality, and aged rice poses a great threat to food safety and human health. The acid value can be employed as a sensitive index for the determination of rice quality and freshness. In this study, near-infrared spectra of three kinds of rice (Chinese Daohuaxiang, southern japonica rice, and late japonica rice) mixed with different proportions of aged rice were collected. The partial least squares regression (PLSR) model with different preprocessing was constructed to identify the aged rice adulteration. Meanwhile, a competitive adaptive reweighted sampling (CARS) algorithm was used to extract the optimization model of characteristic variables. The constructed CARS-PLSR model method could not only reduce greatly the number of characteristic variables required by the spectrum but also improve the identification accuracy of three kinds of aged-rice adulteration. As above, this study proposed a rapid, simple, and accurate detection method for aged-rice adulteration, providing new clues and alternatives for the quality control of commercial rice.

Modification of soy protein isolate using dielectric barrier discharge cold plasma assisted by modified atmosphere packaging.

In this study, soy protein isolate (SPI) was treated by modified atmosphere packaging (MAP) assisted dielectric barrier discharge (DBD) cold plasma (CP) to improve its functional properties. For this reason, SPI powders were treated with DBD-CP at the oxygen ratio of 20 %, 30 %, 40 %, 50 % and 60 %, respectively. The results showed that with the increase of oxygen content, the structure of SPI was destroyed, protein macromolecule depolymerized. However, sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) confirmed that the primary structure of SPI was not disrupted. In addition, when the oxygen content was greater than 40 %, the solubility, water holding capacity, gelling, emulsifying and foaming properties of SPI were significantly improved (p < 0.05). The results showed that high-oxygen packaging can increase the active particles generated during processing, thereby optimizing the structural and functional properties of SPI. Therefore, MAP can serve as a more efficient method for DBD-CP to modify soybean protein.

Surgical operation combined with bronchoscopy in the treatment of fungal empyema: 5 cases report.

RATIONALE: Fungal empyema is a chronic refractory disease. It is difficult to control thoracic infection, and it is faced with the problem of recurrence. How to control the infection and reduce the probability of recurrence is a difficult problem. Surgical operation combined with endobronchial therapy was used to control infection, seal the fistula and eliminate residual cavity and achieved good results. PATIENT CONCERNS: A total of 5 patients with fungal empyema were treated from 2019 to 2021, aged 27 to 72 years, with an average age of 54.8 ±â€…7.6 years. Two cases were on the left side and 3 cases on the right side. DIAGNOSIS: While meeting the diagnostic criteria of empyema, the diagnosis of fungus in pus culture or the discovery of fungus in deep tissue pathology confirmed the diagnosis of fungal empyema in the 5 cases. INTERVENTIONS: Through surgical operations combined with bronchoscopy and individualized treatment, the infection was controlled, the fistulas were blocked, and the pus cavity was filled. OUTCOMES: After 11 to 30 months of follow-up, the muscle flap in the abscess cavity was mildly atrophied, and there was no recurrence of empyema. Three patients who completed the second-stage operation had their chest tubes removed and returned to normal life. The 2 patients who did not complete the second-stage operation had no recurrence of thoracic infection and no recurrence of cough or fever, and their quality of life was greatly improved. LESSONS: Surgical operation combined with bronchoscopy is a reliable method for the treatment of fungal empyema, which can find and plug the fistula more efficiently and eliminate the residual cavity by surgery to avoid recurrence. Therefore, it is a recommended treatment method.

Effect of Propofol Intravenous Anesthesia Combined with Press-Needle Therapy on Analgesic Effect during Painless Abortion.

Objective: To discover the effect of propofol intravenous anesthesia along with press-needle therapy on analgesic effect during painless abortion. Methods: A total of 128 cases who experienced painless abortion in our hospital from January 2019 to August 2021 were recruited as the research subjects. They were categorized into control and observation groups through the haphazard number table approach, with 64 patients in each group. Propofol intravenous anesthesia was given to the control group, and the observation group was given combined anesthesia with press-needle on this basis. Ramsay score, hemodynamic indexes, operation-related indexes, and postoperative recovery were studied between the two groups before anesthesia (T0), at the time of uterine aspiration (T1), promptly following the operation (T2), and at the recovery time of directional force (T3). The stress state and the level of pain mediators in the two groups of sufferers were observed at each time period, and the visual analogue scale (VAS) was employed to assess the degree of postoperative uterine contraction pain. Results: Ramsay score at T1 and T2 time points in observation group was lesser than that in control group (P < 0.05). There existed no meaningful discrepancies in operation time and recovery time between both groups (P > 0.05). The total dosage of propofol in the observation group was lesser compared to that in the control group, and the recovery time of directional force was much shorter compared to that in the control group (P < 0.05). There existed no meaningful discrepancies in perioperative diastolic blood pressure (DBP), systolic blood pressure (SBP), and heart rate (HR) between both groups (P > 0.05). The levels of norepinephrine (NE), cortisol (Cor), glucose (GLU) and substance P (SP), prostaglandin E2 (PGE2), and 5-hydroxytryptophan (5-HT) in the observation group were lesser than those in the control group immediately after surgery and 24 hours following the operation (P < 0.05). There existed no meaningful discrepancies in vaginal bleeding time, endometrial thickness 3 weeks after operation, and time to start menstruating between both groups (P > 0.05). The score of VAS for the observation group was lesser than that of the control group at 10 min and 30 min after operation (P < 0.05). There existed no substantial discrepancy in the incidence of negative reactions between both groups (P > 0.05). Conclusion: Propofol intravenous anesthesia combined with press-needle therapy can ameliorate the analgesic impacts during painless abortion, reduce postoperative uterine contraction pain, inhibit the release of postoperative pain mediators, and improve the stress state of the body.

Video-assisted thoracoscopic surgery lobectomy for giant intralobar pulmonary sequestration: A case report.

RATIONALE: Pulmonary sequestration, which can be divided into 2 main types: intralobar pulmonary sequestration (IPS) and extralobar pulmonary sequestration, is an uncommon congenital condition for which surgical resection is usually indicated. Video-assisted thoracoscopic surgery, as compared with open thoracotomy, has increasingly become the preferred operative procedure in the treatment of PS, owing to less postoperative pain and faster recovery. This report describes a rare and challenging case with a giant IPS undergoing video-assisted thoracic lobectomy. PATIENT CONCERNS: A 39-year old woman suffered from recurrent pneumonia for nearly 3 years. An enhanced computed tomography scan performed in our hospital revealed a 12.0 cm × 10.0 cm-sized IPS in the left lower lobe, supplied by an 8-mm aberrant artery originating from the descending thoracic aorta. DIAGNOSIS: Histology of the resected lobe confirmed the diagnosis of giant intralobar pulmonary sequestration associated with infection. INTERVENTIONS: Thoracoscopic left lower lobectomy was performed. OUTCOMES: The patient has been discharged from the hospital on the ninth day after surgery with an uneventful recovery, she was in good health after a 1-year follow-up. LESSONS: Although full of challenges, thoracoscopic lobectomy for giant IPS is a safe and feasible surgical procedure associated with reduced surgical trauma and postoperative pain as well as improved cosmetic results compared with traditional thoracotomy.

Bilirubin Improves Gap Junction to Alleviate Doxorubicin-Induced Cardiotoxicity by Regulating AMPK-Axl-SOCS3-Cx43 Axis.

Doxorubicin induces severe cardiotoxicity, accompanied by the high level of bilirubin in the blood. The conventional wisdom is that bilirubin is considered as a marker of liver damage. By contrast, here we aim to explore the potential protective effect of bilirubin on doxorubicin-induced cardiotoxicity, and investigate the mechanism for drug development. Doxorubicin was used to establish cardiotoxicity model in vitro and in vivo. The electrocardiogram (ECG), echocardiography and molecular biological methods were used to detect the effects of bilirubin on doxorubicin-induced cardiotoxicity. Consecutive intraperitoneal injection of bilirubin for 7 days significantly attenuated doxorubicin-induced arrhythmia, prolonged survival time and reduced the levels of aspartate aminotransferase (AST), lactate dehydrogenase (LDH), creatine kinase MB (CK-MB) and α-hydroxybutyrate dehydrogenase (α-HBDH) in mice. Bilirubin also markedly inhibited doxorubicin-induced phosphorylation of c-Jun N-terminal kinase (JNK) and connexin 43 (Cx43), and improved gap junction function in vitro and in vivo. In addition, bilirubin activated adenosine 5'-monophosphate (AMP)-activated protein kinase (AMPK) and induced suppressor of cytokine signaling 3 (SOCS3) expression, which was abolished by Axl inhibition. Moreover, pretreatment with AMPK agonist or AMPK inhibitor could mimic or abolish the cardioprotective effect of bilirubin on H9C2 cells in vitro, respectively. Altogether, bilirubin upregulates gap junctions' function to protect against doxorubicin-induced cardiotoxicity by activating AMPK-Axl-SOCS3 signaling axis. We enrich the physiological function of bilirubin, and provide theoretical support for drug development.

Paeoniflorin Inhibits ASK1-TF Axis by Up-Regulating SOCS3 to Alleviate Radiation Enteritis.

Radiation enteritis is one of the main adverse effects of radiotherapy, presenting with a poorly understood etiology and limited options for therapy. Intestinal inflammation and ischemia are the core mechanisms of radiation enteritis. Suppressor of cytokine signaling 3 (SOCS3) is an endogenous "inflammation brake." We hypothesized that paeoniflorin, a pinane monoterpene bitter glycoside, could increase SOCS3 expression to reduce inflammation and ischemia and improve enteritis in mice. Laser Doppler flowmetry was used to detect changes in intestinal blood flow. RAW264.7 and human umbilical vein endothelial cells were used to investigate the mechanism of action of paeoniflorin. It was observed that radiation caused high mortality, intestinal inflammatory responses, and low blood flow in mice. Paeoniflorin effectively alleviated intestinal atrophy, prevented thrombosis, improved radiation enteritis, and reduced mortality in mice undergoing radiotherapy. In addition, paeoniflorin increased the release of growth arrest-specific gene 6 (Gas6) and phosphorylation of the Axl receptor, subsequently inducing the expression of SOCS3 and inhibiting the expression of p-apoptosis signal-regulating kinase 1 and tissue factor in vivo and in vitro. Based on our findings, we suggest that paeoniflorin is potentially effective in alleviating radiation enteritis via the activation of the Gas6/Axl/SOCS3 axis and subsequent reduction in intestinal inflammation and ischemia.

Estimating bulk optical properties of AFB1 contaminated edible oils in 300-900 nm by combining double integrating spheres technique with laser induced fluorescence spectroscopy.

An optical detection platform based on laser induced spectroscopy and double integrating spheres techniques was developed to obtain absorption (µa), reduced scattering coefficients (µ's) and fluorescence intensity of oil. The validation experiment carried on liquid phantoms showed that the developed system could achieve high linearity, and the results of spectra analysis indicated that the fluorescence intensity has a significant negative correlation with both µa and µ's. A total of 1620 oils with six categories were detected. The reason for the difference of fluorescence and µa spectra was analyzed by comparing the measured chlorophyll, polyphenol and α-tocopherol contents. Linear discriminant analysis combined with principal component analysis based on fluorescence and µa spectra was employed, to calibrate the AFB1 classification models. The discrimination results manifested that by integrating µa with fluorescence signal, the correct classification rate could be improved by more than 10%, and the false negative rate was greatly reduced.

Lidocaine Alleviates Sepsis-Induced Acute Lung Injury in Mice by Suppressing Tissue Factor and Matrix Metalloproteinase-2/9.

Acute lung injury (ALI) is one of the fatal symptoms of sepsis. However, there were no effective clinical treatments. TF accumulation-induced fibrin deposit formations and coagulation abnormalities in pulmonary vessels contribute to the lethality of ALI. Suppressor of cytokine signaling 3 (SOCS3) acts as an endogenous negative regulator of the TLR4/TF pathway. We hypothesized that inducing SOCS3 expression using lidocaine to suppress the TLR4/TF pathway may alleviate ALI. Hematoxylin and eosin (H&E), B-mode ultrasound, and flow cytometry were used to measure the pathological damage of mice. Gelatin zymography was used to measure matrix metalloproteinase-2/9 (MMP-2/9) activities. Western blot was used to assay the expression of protein levels. Here, we show that lidocaine could increase the survival rate of ALI mice and ameliorate the lung injury of ALI mice including reducing the edema, neutrophil infiltration, and pulmonary thrombosis formation and increasing blood flow velocity. Moreover, in vitro and in vivo, lidocaine could increase the expression of p-AMPK and SOCS3 and subsequently decrease the expression of p-ASK1, p-p38, TF, and the activity of MMP-2/9. Taken together, our study demonstrated that lidocaine could inhibit the TLR4/ASK1/TF pathway to alleviate ALI via activating AMPK-SOCS3 axis.

AMPK activation by ozone therapy inhibits tissue factor-triggered intestinal ischemia and ameliorates chemotherapeutic enteritis.

Chemotherapeutic enteritis is a major dose-limiting adverse reaction to chemotherapy, with few effective drugs in clinic. Intestinal ischemic injury plays prominent role in chemotherapeutic enteritis clinically. However, mechanism is not clear. In this article, irinotecan (CPT-11) was used to establish chemotherapeutic enteritis mice model. Western blotting, gelatin zymography, immunohistochemistry (IHC), Laser Doppler flowmetry (LDF) were used to detect the pathogenesis of ischemia-hypoxia injury. CPT-11 increased levels of tissue factor (TF) both in the blood and in intestines, and decreased the intestinal blood flow in mice. Interestingly, the elevation of TF in the blood displayed "double-peak," which was consistent with the intestinal mucosal "double-strike" injury trend. Intestinal microthrombus and mixed thrombus formation were detectable in chemotherapeutic enteritis. Furthermore, ozone therapy relieved chemotherapeutic enteritis in mice. Ozone inhibited TF expression induced by CPT-11 via activating AMPK/SOCS3, and effectively ameliorated the intestinal mucosal injury in mice. Moreover, ozone autotransfusion therapy effectively attenuated chemotherapeutic enteritis and the blood hypercoagulability in patients. For the first time, we proposed that TF-induced thrombotic intestinal ischemic injury is a core trigger pathological mechanism of chemotherapeutic enteritis, and provided a new treatment strategy, ozone therapy, to suppress TF expression and treat chemotherapeutic enteritis.

Dexmedetomidine inhibits the NF-κB pathway and NLRP3 inflammasome to attenuate papain-induced osteoarthritis in rats.

Context: Dexmedetomidine (Dex) has been reported to have an anti-inflammatory effect. However, its role on osteoarthritis (OA) has not been explored. Objective: This study investigates the effect of Dex on OA rat model induced by papain. Materials and methods: The OA Wistar rat model was induced by intraluminal injection of 20 mL of papain mixed solution (4% papain 0.2 mL mixed with 0.03 mol L-1 l-cysteine 0.1 mL) into the right knee joint. Two weeks after papain injection, OA rats were treated by intra-articular injection of Dex (5, 10, or 20 µg kg-1) into the right knee (once a day, continuously for 4 weeks). Articular cartilage tissue was obtained after Dex treatment was completed. Results: The gait behavior scores (2.83 ± 0.49), PWMT (15.2 ± 1.78) and PTWL (14.81 ± 0.92) in H-DEX group were higher than that of OA group, while Mankin score (5.5 ± 0.81) was decreased (p < 0.05). Compared with the OA group, the IL-1ß (153.11 ± 16.05 pg mg-1), IL-18 (3.71 ± 0.7 pg mg-1), IL-6 (14.15 ± 1.94 pg/mg) and TNF-α (40.45 ± 10.28 pg mg-1) levels in H-DEX group were decreased (p < 0.05). MMP-13, NLRP3, and caspase-1 p10 expression in Dex groups were significantly lower than that of OA group (p < 0.05), while collagen II was increased (p < 0.05). p65 in the nucleus of Dex groups was significantly down-regulated than that of OA group (p < 0.05). Discussion and Conclusions: Dex can improve pain symptoms and cartilage tissue damage of OA rats, which may be related to its inhibition of the activation of NF-κB and NLRP3 inflammasome.

Spontaneous Coronary Artery Rupture Causing Acute Cardiac Tamponade and Cardiogenic Shock.

Spontaneous coronary artery rupture (SCAR) is an extremely rare, life-threatening entity without any previous underlying diseases. The clinical presentation may differ according to the site of the rupture and some patients may deteriorate early into sudden death due to the abrupt evolution of the associated cardiac tamponade and cardiogenic shock.1) The correct diagnosis of SCAR deserves a high level of suspicion. It may be confirmed as a differential diagnosis in patients with cardiac tamponade using transthoracic echocardiography (TTE) and computed tomography angiography (CTA) following emergency pericardiocentesis, and a definite diagnosis can be achieved by selective angiography. Although SCAR is associated with a dismal prognosis, some patients have recovered through emergency surgical operations or catheter interventions.2) We report the case of a patient presenting cardiac tamponade and cardiogenic shock due to spontaneous rupture of the circumflex branch of the left coronary artery, which was successfully isolated by bilateral ligation.

Fast estimation of optical properties of pear using a single snapshot technique combined with a least-squares support vector regression model based on spatial frequency domain imaging.

Spatial frequency domain imaging has great potential in agricultural produce quality control due to its advantage of wide-field mapping of absorption (µa) and reduced scattering (µs') parameters. However, it is not widely adopted in real applications due to the large time cost during image acquisition and inversion calculation processes. In this study, a single snapshot technique was used to obtain ac and dc components (Rd_ac, Rd_dc) of diffuse reflectance of turbid media (phantoms and pears). The validation results for the snapshot method indicate that at the spatial frequency of 1000/3 m-1, it achieved the optimal demodulation, by comparison with the results obtained by the commonly used time-domain amplitude demodulation method. Diffusion approximation, artificial neural network, least-squares support vector machine regression (LSSVR), and LSSVR combined with a genetic algorithm (LSSVR+GA) were then used to predict µa and µs' from the obtained Rd_ac, Rd_dc at the fx of 1000/3 m-1. Validation results indicated that the LSSVR method took the least time to calculate µa and µs' with high performance. The proposed imaging system and algorithm were implemented for the inspection of a pear bruise. Results indicated that the bruise, which is not obviously distinguishable in original gray maps, can show obvious contrast in calculated µa and µs' maps, especially in µa maps. Further, the contrast becomes more obvious with the passage of time. In summary, this study developed a low-cost spatial frequency imaging system and matching software that could realize fast detection of optical properties for a pear with the proposed snapshot and LSSVR algorithms.

Free vastus lateralis musculocutaneous flap transfer for radiation-induced chest wall fistula combined with osteomyelitis: Two case report.

RATIONALE: Chronic chest wall fistula is a refractory and agonizing disease that results from multiple predisposing etiologies, including radiation-induced damage. Successful management remains challenging when this condition is combined with osteomyelitis, and a limited number of reports have been published in the literature concerning this management. PATIENT CONCERNS: Two Chronic chest wall fistula patients were selected to undergo surgery in our hospital because they could not be cured by conventional therapy for several years. One is a 74-year-old female who has received a right radical mastectomy and had radiation therapy 23 years ago; the other is a 59-year-old male who underwent a excision of thyroid cancer and had chemoradiation therapy 20 years earlier. DIAGNOSIS: Both patients were diagnosed with radiation-induced chest wall fistula combined with osteomyelitis. INTERVENTIONS: After total resection of the diseased chest walls, both patients underwent free vastus lateralis musculocutaneous flap transfers, in which the vessels were microvascularly anastomosed to the transverse carotid artery and vein via a subcutaneous tunnel or a direct incision. Histologic evaluations of the specimens demonstrated inflammation and osteomyelitis. OUTCOMES: The patients recovered very well and currently have no recurrence of chest wall fistulae during the postoperative follow-up. LESSONS: It is crucial to not only completely resect chest wall fistulae and the surrounding diseased tissues but also reconstruct the chest wall. Thus, the use of the free vastus lateralis musculocutaneous flap transfer method for radiation-induced chest wall fistulae, combined with osteomyelitis, is a useful option for treatment and is also a feasible and efficient surgical procedure with promising results.