[Non-surgical local treatment for pulmonary aspergilloma].

Pulmonary aspergilloma (PA) is usually secondary to pulmonary cavities. The main purpose of PA treatment is to prevent life-threatening hemoptysis. Many patients cannot tolerate surgical resection, which is considered the preferred treatment. Oral or intravenous antifungal therapy is less effective because PA usually does not invade the blood vessels of the pulmonary cavity. In this case, arterial embolization, local injection with drugs, and radiation therapy can be considered. This article will summarized various non-surgical local treatments for PA (hemoptysis) to refer clinical decision-making.

[Multivariate saturation treatment for pancreatic neuroendocrine neoplasms with liver metastasis].

Pancreatic neuroendocrine neoplasms (pNENs) are relatively rare clinical diseases, accounting for about 4%-5% of all primary pancreatic tumors, and 60% of patients had had distant metastases when pNENs were diagnosed, with liver being the most frequently involved metastatic organ. Currently, treatment options for pNENs with liver metastasis include surgery, local embolization and ablation, chemotherapy, targeted therapy represented by everolimus and bevacizumab, somatostatin receptor therapy and immunotherapy. However, how to accurately evaluate the condition of patients at different stages of the disease, choose the above-mentioned treatment methods and optimize the treatment effect is a hot and difficult research topic. As a new tumor treatment concept in the era of intelligent medicine recently proposed by the author, the concept of multivariate saturation treatment used artificial intelligence technology to integrate existing tumor treatment methods, combined with the individual heterogeneity of patients; used the deep learning technology of artificial intelligence to accurately assess disease stages and predict the possible response of the corresponding treatment; used the robotic surgery platform to adopt the most suitable surgical method for the patient, which was dynamically adjusted at different stages of tumor treatment to maximize and optimize the treatment effect. Multivariate saturation treatment can provide the possibility to achieve the optimal prognosis of the patient.

Ancestry Inference Using the ForenSeqTM DNA Signature Prep Kit.

ABSTRACT: Objective To evaluate the effect of 56 ancestry informative single nucleotide polymorphism （aiSNP） genetic markers in the ForenSeqTM DNA Signature Prep Kit on ancestry inference. Methods A total of 85 samples from five populations including Hebei Han population, Inner Mongolia autonomous region Mongolian population, Tibet autonomous region Tibetan population, Xinjiang Uygur autonomous region Uygur population and Nigerian population were collected. The library was constructed with the ForenSeqTM DNA Signature Prep Kit and sequencing was performed based on the MiSeq FGx Forensic Genomics System. Using universal analysis software （UAS） of ForenSeqTM, principal component analysis （PCA）, Structure and likelihood ratio method was used on the genotyping data of 56 aiSNP markers, respectively, and the genetic relationships between populations and inference of the origin of ancestors were analyzed. Results Among the five populations tested, the four ethnic populations in China （Hebei Han population, Inner Mongolia autonomous region Mongolian population, Tibet autonomous region Tibetan population and Xinjiang Uygur autonomous region Uygur population） could be significantly distinguished from Nigerian population. Xinjiang Uygur autonomous region Uygur individuals were shown as having mixed origins of ancestors and could be distinguished from the other three Chinese populations. However, the other three populations in China （Hebei Han population, Inner Mongolia autonomous region Mongolian population and Tibet autonomous region Tibetan population） could not be effectively distinguished by the system. Conclusion The 56 aiSNP markers in the ForenSeqTM DNA Signature Prep Kit can make accurate ancestry inference from the intercontinental level, but it is not yet able to distinguish between Chinese subpopulations.

Achieving Stable Radiation Pressure Acceleration of Heavy Ions via Successive Electron Replenishment from Ionization of a High-Z Material Coating.

A method to achieve stable radiation pressure acceleration (RPA) of heavy ions from laser-irradiated ultrathin foils is proposed, where a high-Z material coating in front is used. The coated high-Z material, acting as a moving electron repository, continuously replenishes the accelerating heavy ion foil with comoving electrons in the light-sail acceleration stage due to its successive ionization under laser fields with Gaussian temporal profile. As a result, the detrimental effects such as foil deformation and electron loss induced by the Rayleigh-Taylor-like and other instabilities in RPA are significantly offset and suppressed so that stable acceleration of heavy ions are maintained. Particle-in-cell simulations show that a monoenergetic Al^{13+} beam with peak energy 3.8 GeV and particle number 10^{10} (charge >20 nC) can be obtained at intensity 10^{22} W/cm^{2}.

Remifentanil for labour analgesia: a double-blinded, randomised controlled trial of maternal and neonatal effects of patient-controlled analgesia versus continuous infusion.

This trial aimed to compare the maternal and neonatal effects of remifentanil given by patient-controlled analgesia (PCA) or continuous infusion for labour analgesia. Patient controlled analgesia was administered using increasing stepwise boluses from 0.1 to 0.4 µg.kg(-1) (0.1 µg.kg(-1) increment, 2 min lockout, n = 30). Continuous infusion used rates from 0.05 to 0.2 µg.kg(-1) .min(-1) (0.05 µg.kg(-1) .min(-1) increment, n = 30). Dose increments were given on request. Women reported lowest pain scores (median (IQR [range]) of 3 (2-4 [2-5]) for PCA and 4 (3-5.25 [3-7]) for continuous infusion (p = 0.004) at 60 min after the beginning of analgesia. The mean (SD) remifentanil umbilical vein/maternal artery ratio in the PCA and infusion groups were 0.74 (0.45) vs 0.70 (0.52), respectively (p = 0.776). The mean (SD) umbilical artery/umbilical vein ratios were 0.31 (0.12) vs 0.26 (0.07), respectively (p = 0.088). Maternal and neonatal adverse reactions of remifentanil were similar between the two groups. The total remifentanil consumption (median (IQR [range]) during PCA administration was lower than continuous infusion, 1.34 (1.22-1.48 [0.89-1.69]) mg vs 1.49 (1.35-1.61 [1.12-1.70] mg; p = 0.011). The results suggest that remifentanil PCA provides better pain relief and similar placental transfer compared with continuous infusion.

Efficacy of scalp cooling for prevention of chemotherapy induced alopecia: a systematic review and meta-analysis.

OBJECTIVE: The aim of the study was to compare the risk of chemotherapy induced alopecia among patients with scalp cooling therapy, compared to those that did not receive scalp cooling. MATERIALS AND METHODS: A systematic search was conducted in the PubMed, Scopus, Cochrane Database of Systematic Reviews and Google scholar databases. Studies, preferably randomized controlled trials, that compared scalp cooling with no scalp cooling (control) for risk of alopecia or hair loss in patients undergoing chemotherapy were considered for inclusion. The strength of association was presented in the form of pooled adjusted relative risk (RR) for categorical outcomes and weighted mean difference (WMD) for continuous outcomes. Statistical analysis was done using STATA version 16.0. RESULTS: A total of 14 articles were identified, of which 9 were included in the meta-analysis and for the remaining 5 articles, the findings were synthesized descriptively. Compared to control group patients, those that received scalp cooling had 41% lower risk of alopecia [RR 0.59, 95% CI: 0.53, 0.66]. The overall quality of pooled evidence for the risk of alopecia was judged "moderate". There were no differences in the anxiety score [WMD 0.57, 95% CI: -0.55, 1.69], depression score [WMD 0.31, 95% CI: -1.19, 1.80], score reflecting emotional functioning [WMD 0.06, 95% CI: -1.37, 1.49] and social functioning [WMD -8.37, 95% CI: -25.7, 8.93] among the two groups of patients. The pooled evidence suggests that around 66% (95% CI: 37-95%) of the subjects reported some discomfort with use of scalp cooling system. The commonly reported complaints included headache, scalp and neck pain, discomfort due to chill, nausea/vomiting and dizziness. CONCLUSIONS: Findings suggest that the use of scalp cooling, compared to no scalp cooling, reduces the risk of significant hair loss. The acceptability of this cooling system might be limited by a high incidence of reported complaints.

Scaling laws for laser-driven ion acceleration from nanometer-scale ultrathin foils.

Laser-driven ion acceleration has attracted global interest for its potential towards the development of a new generation of compact, low-cost accelerators. Remarkable advances have been seen in recent years with a substantial proton energy increase in experiments, when nanometer-scale ultrathin foil targets and high-contrast intense lasers are applied. However, the exact acceleration dynamics and particularly the ion energy scaling laws in this novel regime are complex and still unclear. Here, we derive a scaling law for the attainable maximum ion energy from such laser-irradiated nanometer-scale foils based on analytical theory and multidimensional particle-in-cell simulations, and further show that this scaling law can be used to accurately describe experimental data over a large range of laser and target parameters on different facilities. This provides crucial references for parameter design and experimentation of the future laser devices towards various potential applications.

Therapeutic effects of chimeric antigen receptor T cells (CAR-T) on relapse/refractory diffuse large B-cell lymphoma (R/R DLBCL): a meta-analysis.

OBJECTIVE: Diffuse large B-cell lymphoma (DLBCL) is the most common non-Hodgkin lymphoma (NHL). This study aimed to systematically evaluate the efficacy of chimeric antigen receptor T cells (CAR-T) in treating relapse/refractory DLBCL (R/R DLBCL) and associated complete-remission rate (CR). MATERIALS AND METHODS: PubMed, Cochrane Library, CNKI, VIP, CBM, and Wanfang databases were searched, and literature was collected up to January 2019. According to inclusion criteria and exclusion criteria, two researchers independently reviewed and screened literature, extracted required data and crossly checked them. This meta-analysis was conducted using RevMan 5.3 software. RESULTS: This study finally included 13 English literatures and 263 cases. There was no heterogeneity among all these studies, therefore, fixed effect model was used. Meta-analysis findings showed that total CR rate of R/R DLBCL treated with CAR-T was 46.8% (95% CI: 0.408-0.533). Subgroup analysis showed that CR rate of CD28 group was slightly higher [52.5%, with 95% confidence interval (CI): 0.441-0.602] compared to that of 4-1BB group (41.5%, with 95% CI: 0.324-0.510). CR rate of CD19 group was slightly higher (49.2%, with 95% CI: 0.429-0.556) compared to that of CD20 group (42.2%, with 95% CI: 0.231-0.639). Funnel chart of total CR rate, co-stimulatory factor, and target antigen demonstrated fundamental symmetry. Moreover, age, HSCT administration, CAR-T cell counts, and drug pre-treatment also affected immunotherapy on CAR-T on R/R DLBCL. CONCLUSIONS: CAR-T treatment for R/R DLBCL demonstrated evident curative effect and high complete remission rate. CAR-T cell immunotherapy would be expected to become mainstream therapy for hematolymph system tumors.

A modified ferric tannate method for visualizing a blood vessel and its usage in the study of spinal cord injury.

STUDY DESIGN: To develop a method for the study of spinal cord injury (SCI) that can visualize the blood vessels and is compatible with hematoxylin and eosin (HE) staining and immunohistochemical techniques. OBJECTIVE: Visualization of the vascular changes is important for the study of SCI. The original ferric tannate method can stain the spinal cord vasculature to its terminals, but the diffuse tannate precipitates spoil the delicacy of the picture. More importantly, it is incompatible with HE staining and immunohistochemical techniques, which is crucial for the study of SCI. We thus aimed to develop a modified ferric tannate method that could meet the requirement for the study of SCI. SETTING: This study was carried out in China. METHODS: The original ferric tannate method involves a two-step procedure: intravascular perfusion of tannic acid, followed by soaking the tissue sections in a solution of ferric chloride. In the modified method both chemicals were delivered through perfusion. RESULTS: In the original method, diffuse ferric tannate precipitates blurred the profile of the vessels. More importantly, it was incompatible with either HE or immunostaining methods. Our modified method stained the blood vessels with clean background and was compatible with both HE staining and immunohistochemical techniques. CONCLUSION: The modified method is far superior to the original method and meets the requirement for the study of SCI.

[Complicated airway foreign body in a child: a case report].

Summary A 9 year-old boy suffering from cough for half a month, fever for 4 days was hospitalized. CT three-dimensional reconstruction showed that a metallic needle-like foreign body within the right main bronchial with pneumonia and atelectasis. In the next day, the boy took examination using an open-tube rigid bronchoscope under general anesthesia. For the first time, the foreign body was jammed in glottis with SpO2 and HR declining. For the second time, the operator found the foreign was not a needle but a thumbtack. Finally, the thumbtack was removed from the airway after short-term paralysis using succinylcholine.

[A case of esophageal tracheal fistula caused by button cell].

Summary Button batteries are a common emergency in children with esophageal foreign bodies, which need to be removed in time,otherwise serious complications will occur. This article reports a case of esophageal tracheal fistula caused by button cell. It is helpful for differential diagnosis and clinical treatment of esophageal foreign bodies in children caused by button cell.

[Analysis of related factors of coins foreign bodies crossing the esophagus in 204 cases of children].

Objective:To analyze the related factors of coins crossing the esophagus by themselves in children. Method:Two hundred and four cases with coin esophageal foreign bodies in our hospital from April 2016 to June 2017 were selected,the sex, age, size and texture of foreign body and the time of foreign body insertion were analyzed.Result:Of the 204 children, 46 had esophageal foreign bodies falling off the digestive tract below the esophagus,44 cases were discharged by themselves，2 children were removed under digestive endoscopy，1 coins formed diverticulum at the entrance of esophagus.Conclusion:Coins pass over the esophagus, basically seen within 24 hours，unrelated to age，sex or coin size，but related to the quality of the coin.

Effects of acute mild and moderate hypoxia on human mood state.

OBJECTIVE: To explore the effects of acute mild and moderate hypoxia on human mood state. METHOD: The mood states of 18 healthy male volunteers were evaluated by self-assessment questionnaires, profile of mood state (POMS) and state anxiety inventory (S-AI) after random exposure to simulated altitude of 300 m (control), 2800 m, 3600 m and 4400 m for 1 h in a hypobaric chamber. RESULT: The data at 300 m level were taken as the baseline control. The negative mood state factor points (tension, fatigue etc.) increased gradually as the altitude level increased while V (vigor-activity) points had a tendency to decrease (P<0.05 or P<0.01). No significant difference was found in the points of (D, A) even under exposure to 4400 m (P>0.05). At the early period of 2800 m exposure the tension points of POMS and S-AI scores were higher than those of control level (P<0.05) then dropped to baseline level when exposure to this altitude for 1 h. CONCLUSION: Exposure to acute mild hypobaric hypoxia at 2800 m for 1 h has adverse effect on mood state of healthy person and the negative effect was further aggravated with the increment of altitude level.

Effects of acute exposure to mild or moderate hypoxia on human psychomotor performance and visual-reaction time.

Objective. The aim of this study was to determine whether psychomotor performance and visual reaction time were affected by acute exposure to mild or moderate hypoxia. Method. Eighteen healthy male volunteers performed finger tapping, simple reaction time (SRT) and 4-choice reaction time (CRT) tests at simulated altitude of 300 m (control), 2800 m, 3600 m and 4400 m for 1 h in a hypobaric chamber. Result. SaO2 decreased from 98% (control) to 90%, 82% and 74% respectively at the various altitudes. All the performance parameters showed no significant change after exposure to 2800 m for 1 h relative to ground level (P>0.05). However the mean reaction time of 4-CRT under 3600 m prolonged and performance decreased as compared with baseline value (P<0.05), and the performance decreased further under 4400 m (P<0.01). No significant difference was found in finger tapping and SRT even under exposure to 4400 m for 1 h. Furthermore, no decrease in correct rate were observed at any altitude (P>0.05). Conclusion. The results from this study demonstrated that there were no measurable impairment of visual reaction time and psychomotor performance under exposure to an altitude of 2800 m for 1 h. However, adverse effects on psychomotor performance were observed under 3600 m and over.