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Background: Metagenomic next-generation sequencing (mNGS) is a high-throughput sequencing technique that identifies a wide array of pathogens directly from clinical specimens. This study evaluates the diagnostic value of mNGS in Pneumocystis jirovecii pneumonia (PJP) and compares its efficacy with traditional detection methods, including Grocott's Methenamine Silver (GMS) staining, serum (1-3)-ß-D-Glucan (BDG) testing, and Lactate Dehydrogenase (LDH) testing. Methods: Seventy-eight patients hospitalized between January 2022 and March 2023 with suspected pulmonary infections were included. Patients were eligible for mNGS if they exhibited symptoms such as fever, cough, dyspnea, or progressive hypoxemia, and met specific clinical criteria for PJP. Specimens obtained included bronchoalveolar lavage fluid, sputum, and peripheral blood. Positive rates and pathogen distributions detected by mNGS and traditional methods were compared. Results: In the PJP group, 25%, 37.5%, and 9.38% of patients had solid organ tumors, corticosteroid use, and skin diseases, respectively, significantly higher than in the non-PJP group. The sensitivity and specificity of mNGS were both 100%, significantly higher than those of serum BDG (sensitivity 50%, specificity 81.8%) and LDH (sensitivity 9.3%, specificity 91.3%). Significant differences in microbial composition between the PJP and Non-PJP groups were observed. mNGS detected multiple mixed pathogens in 96.88% of PJP cases, with 68.75% exhibiting mixed bacterial and viral infections. Notably, 71% of patients improved following antibacterial treatment based on mNGS results. Conclusion: mNGS technology shows superior sensitivity and specificity in diagnosing PJP and guides precise treatment for complex pulmonary infections.
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Fringe projection profilometry is a widely used technique for 3D measurement due to its high accuracy and speed. However, the accuracy significantly decreases when measuring complex texture objects, especially in the junction of different colors. This paper analyzes the causes of errors resulting from complex textures and proposes a height compensation method to revise the error by employing a dual-projector structure. Moreover, the dual-projector is capable of acquiring a pair of errors with opposite signs, which can be utilized to calculate the accurate 3D information after determining the ratio of this pair of errors. Experiments provide significant improvement in measuring complex texture objects, demonstrating the proposed method's ability.
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Background: Clinical appearance and high-frequency ultrasound (HFUS) are indispensable for diagnosing skin diseases by providing internal and external information. However, their complex combination brings challenges for primary care physicians and dermatologists. Thus, we developed a deep multimodal fusion network (DMFN) model combining analysis of clinical close-up and HFUS images for binary and multiclass classification in skin diseases. Methods: Between Jan 10, 2017, and Dec 31, 2020, the DMFN model was trained and validated using 1269 close-ups and 11,852 HFUS images from 1351 skin lesions. The monomodal convolutional neural network (CNN) model was trained and validated with the same close-up images for comparison. Subsequently, we did a prospective and multicenter study in China. Both CNN models were tested prospectively on 422 cases from 4 hospitals and compared with the results from human raters (general practitioners, general dermatologists, and dermatologists specialized in HFUS). The performance of binary classification (benign vs. malignant) and multiclass classification (the specific diagnoses of 17 types of skin diseases) measured by the area under the receiver operating characteristic curve (AUC) were evaluated. This study is registered with www.chictr.org.cn (ChiCTR2300074765). Findings: The performance of the DMFN model (AUC, 0.876) was superior to that of the monomodal CNN model (AUC, 0.697) in the binary classification (P = 0.0063), which was also better than that of the general practitioner (AUC, 0.651, P = 0.0025) and general dermatologists (AUC, 0.838; P = 0.0038). By integrating close-up and HFUS images, the DMFN model attained an almost identical performance in comparison to dermatologists (AUC, 0.876 vs. AUC, 0.891; P = 0.0080). For the multiclass classification, the DMFN model (AUC, 0.707) exhibited superior prediction performance compared with general dermatologists (AUC, 0.514; P = 0.0043) and dermatologists specialized in HFUS (AUC, 0.640; P = 0.0083), respectively. Compared to dermatologists specialized in HFUS, the DMFN model showed better or comparable performance in diagnosing 9 of the 17 skin diseases. Interpretation: The DMFN model combining analysis of clinical close-up and HFUS images exhibited satisfactory performance in the binary and multiclass classification compared with the dermatologists. It may be a valuable tool for general dermatologists and primary care providers. Funding: This work was supported in part by the National Natural Science Foundation of China and the Clinical research project of Shanghai Skin Disease Hospital.
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OBJECTIVE: To compare the cosmetic efficacy of the transplantation of follicles with intact and non-intact hair bulbs in the treatment for vitiligo. METHODS: The single-hair follicle units with intact hair bulbs and un-intact hair bulbs were transplanted into the skin of vitiligo. The diameters of regrowing hair shafts and repigmentation of implanted follicles were detected analyzed by dermatoscopy (Beining BN-PFMF Skin and Hair Visualizer). RESULTS: The survival rates of follicles with intact and non-intact hair bulbs were 60.00% and 50.62%, respectively. The average diameters of hair shafts and repigmentation of the two groups were 92.83 ± 7.26 µm vs 55.86 ± 2.64 µm (p < .05), 2.62 ± 0.13 mm vs 2.63 ± 0.17 mm (p > .05), respectively. CONCLUSION: Single follicle transplantation was an alternative effective choice for the treatment of vitiligo. The skin implanted with follicle with non-intact hair bulb was less hairy.
Subject(s)
Vitiligo , Hair , Hair Follicle/transplantation , Humans , Skin Pigmentation , Treatment Outcome , Vitiligo/surgeryABSTRACT
BACKGROUND: Circular RNA (circRNA) has been confirmed to play a vital role in melanoma progression. OBJECTIVE: The regulatory function of circ_0062270, a novel circRNA, in melanoma progression is unclear. METHODS: Relative expression levels of circ_0062270 and microRNA (miR)-331-3p were determined using qRT-PCR. Cell counting kit 8 assay, EdU staining and flow cytometry were used to measure cell proliferation, cell cycle distribution and apoptosis. The protein levels of proliferation, apoptosis and metastasis-related markers, as well as EPH receptor A2 (EPHA2), were tested using western blot analysis. Besides, cell migration and invasion were evaluated using transwell assay. Meanwhile, the interaction between miR-331-3p and circ_0062270 or EPHA2 was confirmed by dual-luciferase reporter assay or RIP assay. Additionally, tumor xenograft models were constructed to investigate the function of circ_0062270 on melanoma tumor growth in vivo. RESULTS: The expression of circ_0062270 was increased in melanoma tissues and cells. Knockdown of circ_0062270 inhibited proliferation, promoted apoptosis, and repressed metastasis in melanoma. Moreover, circ_0062270 could serve as miR-331-3p sponge, and miR-331-3p could target EPHA2. Furthermore, miR-331-3p inhibitor and EPHA2 overexpression reversed the inhibitory effect of circ_0062270 silencing on melanoma progression. In addition, silenced circ_0062270 also could inhibit melanoma tumor growth in vivo. CONCLUSION: Circ_0062270 accelerated the progression of melanoma through regulating the miR-331-3p/EPHA2 axis, suggesting that circ_0062270 might be a novel potential therapeutic target for melanoma.
Subject(s)
Melanoma/genetics , MicroRNAs/metabolism , RNA, Circular/metabolism , Receptor, EphA2/genetics , Skin Neoplasms/genetics , Animals , Apoptosis/genetics , Cell Line, Tumor , Cell Movement/genetics , Cell Proliferation/genetics , Disease Progression , Female , Gene Expression Regulation, Neoplastic , Gene Knockdown Techniques , Humans , Male , Melanoma/diagnosis , Melanoma/pathology , Melanoma/surgery , Mice , Middle Aged , Neoplasm Staging , RNA, Circular/genetics , Skin/pathology , Skin Neoplasms/diagnosis , Skin Neoplasms/pathology , Skin Neoplasms/surgery , Xenograft Model Antitumor AssaysABSTRACT
OBJECTIVE: In most cases, dermatofibrosarcoma protuberans (DFSP) is characterized by the chromosomal translocation t (17; 22) (q22; q13) that leads to a fusion of collagen type 1 alpha 1 (COL1A1) and platelet-derived growth factor beta chain (PDGFB). Recently, next-generation sequencing (NGS) has been reported to detect fusion transcripts in some malignancies. Therefore, the present study aimed to evaluate the utility of the targeted NGS in detecting the COL1A1-PDGFB fusion in patients with DFSP. METHODS: We designed a targeted DNA capture panel to tile along the fusion regions, including exon, intron, and untranslated regions of the COL1A1 and PDGFB. A cohort of 18 DNA samples extracted from formalin-fixed, paraffin-embedded tissues was used to evaluate the targeted NGS. The results were compared with that of fluorescence in situ hybridization (FISH). RESULTS: The COL1A1-PDGFB fusion was identified in 13 of 18 cases (72.2%) by targeted NGS assay. PDGFB breakpoints were constantly found in exon 2, while breakpoints in COL1A1 varied from exon 15 to 46. Of these 18 cases assayed by FISH, 12 (66.7%) exhibited COL1A1-PDGFB fusion signals. One case (P9), which was FISH-negative, was demonstrated with the fusion by targeted NGS and validated by PCR and Sanger sequencing. The targeted NGS results showed a high concordance with the results of the FISH assay (94.4%). CONCLUSION: Our study reported a targeted NGS assay for detecting the breakpoints of the COL1A1-PDGFB fusion gene, which can be implemented in diagnosing patients with DFSP.
Subject(s)
Collagen Type I, alpha 1 Chain/genetics , Dermatofibrosarcoma/diagnosis , Pathology, Molecular , Proto-Oncogene Proteins c-sis/genetics , Adolescent , Adult , Aged , Child , Chromosome Breakpoints , Dermatofibrosarcoma/genetics , Dermatofibrosarcoma/pathology , Female , High-Throughput Nucleotide Sequencing , Humans , In Situ Hybridization, Fluorescence , Male , Middle Aged , Oncogene Proteins, Fusion/genetics , Translocation, Genetic , Young AdultABSTRACT
BACKGROUND: Steatocystoma multiplex (SM) is a disorder of the pilosebaceous unit characterized by multiple sebum-containing dermal cysts. Psychological distress of patients is always derived from these undesirable lesions. Although various treatments have been attempted to improve cosmetic outcomes, no optimal treatment strategy has been established to date.. AIMS: To provide a facile and practical surgical technique combined with tissue adhesive for the treatment of steatocystoma multiplex. METHOD: Forty patients diagnosed as SM were treated with simple modified surgical technique. After local anesthesia, the surface skin was incised about 1-2 mm using a No. 11 blade. When the wall was punctured, the cyst should be squeezed to cause the contents to come out first. Then, we used single toothed forceps which were inserted through the narrow incision. When the cyst was exposed, the mosquito forceps grasp the portion of the cyst and pull it out gently. Then, the incisions were pressed locally, and tissue adhesive was employed to align them when there was no bleeding. We just took approximately 1-2 minutes to excise one cyst completely. RESULT: We successfully treated forty SM patients with our simple modified surgical technique. After treatment, excellent clinical outcomes and minimal adverse effects were observed in this study. And more importantly, no recurrence was found 12 months after the surgery. CONCLUSION: Our simple modified surgical technique was proved to be practical and have excellent results in the long run. We highly recommend this treatment technique as the first-line therapy for SM.
Subject(s)
Cysts , Epidermal Cyst , Steatocystoma Multiplex , Tissue Adhesives , Epidermal Cyst/surgery , Humans , Neoplasm Recurrence, Local , Tissue Adhesives/therapeutic useABSTRACT
PURPOSE: To investigate species diversity and prevalence of antifungal resistance among clinical isolates of Aspergillus spp. in Shanghai, China. PATIENTS AND METHODS: In this study, the Aspergillus spp. isolates were analyzed by multilocus sequence typing (MLST) targeting the internal transcribed spacer (ITS) regions, and partial ß-tubulin (BenA) and calmodulin (CaM) genes. The susceptibilities of these isolates to nine antifungal agents were determined according to the protocol in document M38-A3 established by the Clinical and Laboratory Standards Institute (CLSI). RESULTS: The most common Aspergillus spp. was A. fumigatus (58.2%), followed by the A. flavus complex (23.5%), and A. niger complex (15.3%). Isolates belonging to A. tamarii and A. effusus of the A. flavus complex and A. tubingensis and A. awamori of the A. niger complex were identified. Moreover, several mutations were found in the azole target cyp51A gene (TR46/Y121F/T289A and F46Y, G89G, M172V, N248T and D255E) in azole-resistant isolates of A. fumigatus. CONCLUSION: The results of our study revealed a diversity of species in the lower respiratory tract of inpatients in Shanghai and approximately 9% of our isolates were resistant to at least one of the triazole antifungals. Formulation of local treatment strategies to combat emerging azole resistance and species diversity in clinically relevant Aspergillus spp. is needed.
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BACKGROUND: The incidence of hair loss among Chinese male has increased to 21.3 per hundred. Hair restoration has been an effective technique. Detailed hair distribution has a tremendous impact on the surgery design. OBJECTIVE: To investigate the pattern of hair distribution in Chinese young adult males. METHODS: A total of 1000 males without hair disease were enrolled. We evaluated the locations of the main anatomical marks at different sites on the scalp and analyzed the hair density and follicular unit structure using the standard photographs and trichoscope. RESULTS: The hairline shapes were classified as: linear (48.7%), linear with central protrusion (27.9%), round (9.8%), round with central protrusion (13.7%). The average height of the median line was 6.78â±â0.75âcm, the ratio of the median line and the forehead height was 0.333. The average distance from the parietal whorl to the vertical bimeatal line was 7.05â±â3.32âcm, and most of the PWs were on the right (51.4%) and had a clockwise pattern (73.3%). The hair density was 171.12â±â18.32âhairs/cm in the vertex. 1-hair follicular units were (75.90% and 56.39%) in anterior hairline and temporal area. CONCLUSION: Our study clearly assisted understanding of scalp anatomy and hair distribution in Chinese young adult males.
Subject(s)
Hair/anatomy & histology , Scalp/anatomy & histology , Adolescent , Adult , Alopecia/ethnology , Alopecia/surgery , Anatomic Landmarks , China , Dermoscopy , Hair/diagnostic imaging , Hair Follicle/anatomy & histology , Hair Follicle/diagnostic imaging , Humans , Male , Photography , Scalp/diagnostic imaging , Young AdultSubject(s)
Coinfection/epidemiology , Cryptococcosis/complications , Cryptococcosis/epidemiology , Tuberculosis/complications , Tuberculosis/epidemiology , Adolescent , Adult , Antifungal Agents/therapeutic use , Antitubercular Agents/therapeutic use , Child, Preschool , China/epidemiology , Female , Humans , Male , Middle Aged , Treatment OutcomeSubject(s)
Aspergillosis/microbiology , Lupus Erythematosus, Systemic/microbiology , Skin Ulcer/microbiology , Administration, Oral , Anti-Inflammatory Agents/administration & dosage , Antifungal Agents/administration & dosage , Aspergillosis/complications , Aspergillosis/drug therapy , Female , Humans , Injections, Intravenous , Itraconazole/administration & dosage , Lupus Erythematosus, Systemic/complications , Lupus Erythematosus, Systemic/drug therapy , Middle Aged , Prednisone/administration & dosage , Skin/drug effects , Skin/microbiology , Skin Ulcer/complications , Skin Ulcer/drug therapy , Skin Ulcer/surgeryABSTRACT
Cryptococcus neoformans invades the central nerve system through endocytosis by the vascular endothelia. S100A10 interacts with Ca(2+) channel proteins in the vascular endothelia and regulates the filamentous actin network. We hypothesized that S100A10 was involved in the pathogenesis of cryptococcosis and sought to investigate here the effect on the phagocytosis and growth of C. neoformans of S100A10 downregulation by small interfering RNA in murine brain microvascular endothelial cell (MBMECs). We found that S100A10 downregulation significantly reduced the intracellular Ca(2+) concentration (P < 0.05). Additionally, suppression of S100A10 expression was associated with significantly reduced rate of phagocytosis and budding of C. neoformans. The capsule of intracellular C. neoformans also became thicker after S100A10 was knocked down. The findings demonstrated that knockdown of S100A10 in MBMEC could attenuate the growth of intracellular C. neoformans. We inferred that the S100A10 may play an important role in transpenetration of C. neoformans across the vascular endothelia.