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A young male patient with abdominal pain and fever was diagnosed as acute hyper-triglyceridemicpancreatitis is clear. During the recovery of pancreatitis, the patient developed acute acalculous cholecystitis, as well as carbapenem-resistant Enterobacter infection and Cytomegaloviremia, and had anaphylaxis for several times after the use of antibiotics, which cannot be completely explained by drug allergy. This paper analyzes the possible causes of multiple diseases in the same patient in detail.
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Objective:To investigate the risk factors of central lymph node metastasis (CLNM) in cN0 paillary thyroicl microcarcinoma (PTMC) and to establish a nomogram model for predicting the probability of cN0 PTMC CLNM.Methods:The clinicopathological data of 192 patients with cN0 PTMC admitted to the Department of General Surgery of the Second Hospital of Lanzhou University from Aug. 2016 to Aug. 2020 were retrospectively analyzed. There were 41 males and 151 females, 50 with CLNM and 142 without CLNM. The patients were divided into 2 groups according to the presence or absence of pathologically confirmed CLNM. Patient’s age, gender, tumor diameter, multiple, with Hashimoto’s disease, with nodular goiter, with or without near the posterior dorsal membrane, aspect ratio >1, with or without extratumoral infiltration, with or without lymphadenopathy, TSH levels, and TG levels were statistically analyzed. Pearson chi-square test was used to analyze the count data of hypothesis test, and the R language software package was used for Logistic multivariate analysis. The entry conditions were screened by stepwise regression to establish a nomogram prediction model, and the Bootstrap method was used for model verification. P<0.05 was considered statistically significant. Results:Multivariate logistic analysis showed that extratumoral invasion ( P=0.032) , presence of lymphadenopathy ( P=0.010) , and TG>68 μg/L ( P=0.007) were risk factors for central lymph node metastasis. The optimal model was established by stepwise regression. The factors included tumor diameter ≥0.5 cm, nodular goiter, extratumoral invasion, lymphadenopathy and TG>68 μg/L (AIC: 212.27) . The nomogram model was established according to the above risk factors. The consistency index (c-index) was 0.711. The results of calibration graph drawing and internal and external validation demonstrated its good consistency and applicability. Conclusion:Extratumoral invasion, lymphadenopathy, and TG>68 μg/L are risk factors for cN0 PTMC CLNM, and the nomogram established in the study can effectively predict the CLNM rate in patients with cN0PTMC and contribute to clinicians’ diagnosis and treatment decisions.
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By analyzing and comparing the IVD product classification supervision system in the EU's new IVDR, old IVDD and related guidance documents, concepts of related regulatory reforms were analyzed and explored, to provide references for industrial personnel to understand and master the new EU IVD classification system, and for China's ongoing classification management reform.
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European Union , Industry , Reagent Kits, DiagnosticABSTRACT
Three cases of flagellate shiitake mushroom dermatitis caused by Pleurotus ostreatus, Auricularia auricula, and Flammulina velutipes respectively were reported. Case 1, a 45-year-old male patient, developed multiple flagellate erythematous patches and papules on the trunk, axillae and abdomen without any subjective discomfort 8 hours after ingestion of a large amount of grilled Pleurotus ostreatus. Case 2, a 33-year-old female patient, developed multiple flagellate erythematous patches with mild swelling and itching on the back 1.5 days after consuming a fresh Auricularia auricula salad, and millet-sized papules were densely distributed on the erythematous patches. Case 3, a 54-year-old female patient, developed cord-like, flagellate edematous erythema and papules on the neck, trunk and proximal extremities 72 hours after consuming Flammulina velutipes. Histopathological examination of the dorsal lesions in case 3 showed epidermal spongiosis, intraepidermal blisters, papillary dermal edema, superficial dermal vasodilation, erythrocyte extravasation, inflammatory infiltration composed mainly of lymphocytes around dilated blood vessels, and a few scattered eosinophils. The 3 patients were all diagnosed with flagellate shiitake mushroom dermatitis. Case 1 received no treatment, while cases 2 and 3 were symptomatically treated with topical fluticasone propionate ointment, and achieved recovery of skin lesions after 1 week.
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Objective To explore the method and application value of near-infrared fluorescence-guided total parathyroidectomy (TPTX) in patients with secondary hyperparathroidism (SHPT) using indocyanine green (ICG).Methods The clinical data of 38 patients with SHPT undergoing fluorescence-guided TPTX from Dec.2013 to Jun.2017 were collected.All patients were treated with intravenous injection of ICG 30 minutes before operation.Near-infrared fluorescence imaging of parathyroid glands during surgery was observed and all parathyroid glands were resected.The preoperative and postoperative levels of parathyroid hormone,serum calcium and serum phosphorus were recorded to assess total resection and surgical efficacy.The complications such as hemorrhage and wound infection were observed.Results The fluorescence-guided TPTX was successful in all patients.The operation time was 75 to 225 mins.A total of 149 parathyroid glands were localized by fluorescence imaging,including 11 escaped glands by preoperative imaging examination.However,another 7 fluorescence-labeled tissue was inflammatory lymph node or fibrous adipose tissue.Intraoperative fluorescence-guided technique could identify the location and number of parathyroid glands.The level of parathyroid hormone before operation and 30 minutes after resection was (1797.3±838.8) pg/ml and (187.2±109.2) pg/ml,respectively,and maintained low level after operation.The differences were statistically significant(F=155.001,P=0.000).Compared with the level before surgery,the postoperative level of serum calcium and serum phosphorus decreased to normal range with significant differences (F=41.842,P=0.000;F=49.491,P=0.000).No perioperative death happened.One patient sufferred neck hematoma due to heparin,and one patient developed hypertension.No complications such as wound infection and pulmonary infection occurred to any patient.Conclusions Intraoperative fluorescence-guided TPTX using ICG in the patient with SHPT is safet and feasible,and is expected to be a novel technique for intraoperative dynamic examination and real-time localization of parathyroid gland.
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<p><b>Background</b>In the current society, infertility related to age has become a social problem. The in vitro fertilization (IVF) success rate in women with poor ovarian response (POR) is very low. Dandelion extract T-1 (DE-T1) is an effective component of the extract from the leaves and stems of Taraxacum officinale, which is one of the medicines used in some patients with POR, but its molecular mechanism remains unclear.</p><p><b>Methods</b>Following IVF, ovarian granulosa cells (GCs) of sixty patients were extracted and divided into normal ovarian response (NOR) and POR groups. GCs were cultured in a dose-dependent and time-dependent manner with DE-T1, proliferation of GCs was determined by Cell Counting Kit-8 assay, and mRNA levels of insulin-like growth factor 1 receptor (IGF-1R), luteotropic hormone receptor (LHR), follicle-stimulating hormone receptor (FSHR), LHR, and CYP19A1 (aromatase) were determined by quantitative polymerase chain reaction. Progesterone and estradiol (E2) concentrations were determined by enzyme-linked immunosorbent assay.</p><p><b>Results</b>The cell viability gradually increased with the progressive increase in the DE-T1 concentration. Compared with the control group (without DE-T1), the mRNA expressions of FSHR, LHR, IGF-1R, and CYP19A1 were upregulated after the addition of DE-T1, especially in the 2.5% DE-T1 group (P < 0.01). The expression of IGF-1R was upregulated approximately 25 times (24.97 ± 4.02 times) in the POR group with 2.5% DE-T1. E2 and progesterone levels increased with the increasing DE-T1 concentration. There were highly significant differences in the E2 and progesterone secretion between the NOR and POR groups (P < 0.01).</p><p><b>Conclusion</b>DE-T1 may promote steroid hormone synthesis by promoting GC proliferation and upregulating GC receptor expression, thereby improving ovarian endocrine function.</p>
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<p><b>OBJECTIVE</b>To explore the mechamisms of mitochondria-mediated pathway in apoptosis of platelets resulted from in immune induced bone marrow failure.</p><p><b>METHODS</b>Thirty C57BL/6 mice were randomly divided into 3 groups (10 mice in each group): normal group, model group, cyclosporine A(CsA) group. Mouse model of immune bone marrow failure were established. After mouse model was successfully established, the mice in normal group and model group were given saline orally, the mice in CsA group was treated with CsA orally. Blood routine examination of mice in each group was performed by automatic blood cell analyzer; the mitochondrial membrane potential(ΔΨm), cytochrome C(Cyt C), phosphatidylserine (PS), Cawere measured by flow cytometry; expression of BAX, BAK, caspase-3, caspase-8, caspase-9 was detected by using Western blot method, the changes of bone marrow platelet ultrastructure were observed under transmission electron microscope.</p><p><b>RESULTS</b>Compared with normal group, the platelet count of model group decreased significantly, while the level of ΔΨm, caspase-3, caspase-8, caspase-9 significantly decreased, the level of Cyt C, PS, Ca, BAX, BAK increased significantly (P<0.05). Compared with the model group, the platelet count of CsA group increased obviously, while the level of ΔΨm, caspase-3, caspase-8, caspase-9 of CsA group increased significantly, the level of Cyt C, PS, Ca, BAX, BAK of CsA group decreased significantly (P<0.05). Electron microscopy showed that compared with the model group, platelet damage in CsA group were alleviated.</p><p><b>CONCLUSION</b>mitochondrial pathway plays an important role in the reduction of platelet resulted from immune bone marrow failure.</p>
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In order to the macroscopic geometry distributions of vascular bundles in Moso bamboo tubes. The circumference of bamboo tubes was measured, used a simple quadratic diameter formula to analyze the differences between the tubes in bamboo culm, and the arrangement of vascular bundles was investigated by cross sectional images of bamboo tubes. The results shown that the vascular bundles were differently distributed in a bamboo tube. In the outer layer, the vascular bundles had a variety of shapes, and were aligned parallel to each other. In the inner layers, the vascular bundles weren't aligned but uniform in shape. It was concluded that the vascular bundle sections arranged in parallel should be separated from the non-parallel sections for the maximum bamboo utilization
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MathematicsABSTRACT
<p><b>OBJECTIVE</b>To construct the recombinant baculovirus with NA gene of Influenza H1N1 virus.</p><p><b>METHODS</b>Full-length NA gene of Influenza virus H1N1 (A/PR/8/34) was amplified by PCR and inserted into pFastBacdual vector to construct the recombinant baculovirus transfer vector pFBD-NA. Recombinant shuttle vectors rBacmid-NA was then obtained after transforming DH10B competent cells containing bacmid plasmids. After transfecting into sf9 cells, recombinant baculovirus rBac-NA was obtained. The rBac-NA genome was extracted and identified by PCR. NA protein expressed by recombinant baculovirus-infected sf9 cells was determined by IFA, Western Bolt and ELISA.</p><p><b>RESULTS</b>PCR results proved that recombinant shuttle vectors rBacmid-NA was successfully constructed. NA protein was detected by IFA and showed strong specific green fluorescence on the surface of infected cells. NA protein was recognized by two polyclonal antibodies specific for NA in Western Blot. ELISA showed specific reaction of recombinant NA protein with mouse polyclonal antibody against influenza virus (PR8), indicating high antigenicity.</p><p><b>CONCLUSION</b>Recombinant baculovirus rBac-NA that expresse NA protein of influenza virus was successfully constructed. This work provides a basis for further study on NA protein function and novel influenza vaccine development.</p>