Rosai-Dorfman disease manifesting as a solitary mass with fat in the thymus a case report.

BACKGROUND: Sinus histiocytosis with massive lymphadenopathy, also known as Rosai-Dorfman disease, is a rare, self-limiting disease that predominantly affects children and young adults. Moreover, the disease is characterized by painless bilateral cervical lymphadenopathy in 95% of the patients. However, few reports are available on the Rosai-Dorfman disease of the thymus. CASE PRESENTATION: We report a rare case of thymic Rosai-Dorfman disease detected using computed tomography. During a medical examination, a 50-year-old man underwent a chest computed tomography scan, which revealed an anterior mediastinal single mass with fat in the thymus. A thymectomy was performed to completely remove the tumor using a thoracoscopic technique due to a clinical suspicion of thymoma. Furthermore, Rosai-Dorfman disease was confirmed using histological and immunohistochemical analyses. CONCLUSIONS: To the best of our knowledge, this is the sixth case of thymus-affecting solitary Rosai-Dorfman disease with histological and immunohistochemical evidence. Fat in the thymus, as was present in this case, has never been described in Rosai-Dorfman disease previously. Our results highlight the challenge of diagnosing this uncommon tumor before surgery, and more cases need to be reported to help with the preoperative diagnosis of such a rare tumor.

Feasibility and validity of using deep learning to reconstruct 12-lead ECG from three­lead signals.

BACKGROUND: In the field of mobile health, portable dynamic electrocardiogram (ECG) monitoring devices often have a limited number of lead electrodes due to considerations, such as portability and battery life. This situation leads to a contradiction between the demand for standard 12­lead ECG information and the limited number of leads collected by portable devices. METHODS: This study introduces a composite ECG vector reconstruction network architecture based on convolutional neural network (CNN) combined with recurrent neural network by using leads I, II, and V2. This network is designed to reconstruct three­lead ECG signals into 12­lead ECG signals. A 1D CNN abstracts and extracts features from the spatial domain of the ECG signals, and a bidirectional long short-term memory network analyzes the temporal trends in the signals. Then, the ECG signals are inputted into the model in a multilead, single-channel manner. RESULTS: Under inter-patient conditions, the mean reconstructed Root mean squared error (RMSE) for precordial leads V1, V3, V4, V5, and V6 were 28.7, 17.3, 24.2, 36.5, and 25.5 µV, respectively. The mean overall RMSE and reconstructed Correlation coefficient (CC) were 26.44 µV and 0.9562, respectively. CONCLUSION: This paper presents a solution and innovative approach for recovering 12­lead ECG information when only three­lead information is available. After supplementing with comprehensive leads, we can analyze the cardiac health status more comprehensively across 12 dimensions.

Metformin attenuates inflammation and boosts autophagy in the liver and intestine of chronologically aged rats.

BACKGROUND: Our previous studies found that autophagy levels in liver and intestinal segments of naturally aging rats were downregulated, and the expression of pro-inflammatory factors was increased. The increased expression of pro-inflammatory factors might be related to the downregulation of autophagy. AMPK is the most critical upstream targeting and regulating molecule of autophagy, and Metformin, as an agonist of AMPK, has the effects of anti-inflammation and anti-aging. We pretreated 29-month-old naturally aging rats with Metformin for a short period and observed the changes in autophagy levels and pro-inflammatory factors in the liver, ileum, and colon after 31 days of intervention and preliminarily investigated the mechanism of its action. METHODS: 29-month-old SPF male Wistar rats were divided into three groups: The control group, the Metformin 100 mg/kg intervention group, and the Metformin 250 mg/kg intervention group, with eight rats in each group. At 29 months, different concentrations of Metformin (100 mg/kg, 250 mg/kg) were given by gavage once a day until 30 months, and the control group was kept generally until 30 months. Western Blot was used to assess the expression levels of AMPK, P-AMPK, LC3, and P62 proteins in the liver and intestinal tissues. Intestinal and liver tissues were immunofluorescence labeled for LC3 and P62 proteins. Moreover, RT-qPCR was conducted to detect the expression levels of pro-inflammatory factors IL-1ß, TNF-α, IL-6, and MMP-9 mRNA in liver and intestinal tissues. RESULTS: Short-term Metformin pretreatment (31 days) in naturally aging rats (29 months old) increased autophagy levels and down-regulated the expression of various pro-inflammatory cytokines (IL-1ß, TNF-α, MMP-9, and IL-6) in various intestinal segments and the liver-the expression of LC3II protein enriched with the increase of Metformin concentration. The level of P62 protein decreased with the accumulation of Metformin concentration. And a higher concentration of Metformin was associated with increased expression of P-AMPK protein. CONCLUSIONS: Metformin intervention can boost the autophagy level in the liver and intestine and reduce the expression of aging-related inflammatory factors in aged rats, and these effects may be related to the increase of the AMPK phosphorylation level.

[Response of River Ecosystem Health Status to Water Environmental Factors in the Middle Reaches of Yarlung Zangbo River].

River ecological health assessments are the premise for protecting river biodiversity and curbing river water environment deterioration. To explore the river ecosystem health status and its response mechanism to water environmental factors in the middle reaches of the Yarlung Zangbo River, phytoplankton samples were collected during July and October 2021, and water environmental factors were measured. The phytoplankton species were identified, and their cell abundance and biomass were calculated. The phytoplankton integrity index was constructed to evaluate the ecological health status of the river. The temporal and spatial distribution characteristics of water environmental factors and phytoplankton community, as well as the correlation between P-IBI value and community parameters and water environmental factors were analyzed. The results showed that the difference in water environmental factors was not evident in time but was significant in space. The average cell abundance and biomass of phytoplankton were in the order of wet season>dry season and main stream>tributaries. Diatoms dominated the community, and pH and WT were the major water environmental factors driving the spatial and temporal distributions of phytoplankton. The ecological health status of the middle reaches of the Yarlung Zangbo River was "healthy to sub-healthy." The river health status was better than that of the dry season, and that of the tributaries was better than that of the main stream. EC, TUR, WT, NO3--N, and NH4+-N were the major water environmental factors affecting the ecological health status of the river reach, which could be affected by the direction and rate of phytoplankton community succession. It is involved in and affects the process of material circulation and energy flow of the river ecosystem, thereby driving the ecological health of the middle reaches of the Yarlung Zangbo River.

Distribution patterns and community assembly processes of eukaryotic microorganisms along an altitudinal gradient in the middle reaches of the Yarlung Zangbo River.

Eukaryotic microorganisms play an important role in the biogeochemical cycles of rivers. Dynamic hydrological processes in rivers are thought to influence the assembly processes of eukaryotic microbes, as well as affecting local geomorphology. These processes have not been extensively studied for eukaryotic river microbes in extreme environments on the Tibetan Plateau. This study used 18S rDNA gene amplification sequencing, a neutral community model, and a null model to analyze the spatial and temporal dynamics and assembly processes of eukaryotic microbial communities in the middle reaches of the Yarlung Zangbo River. We conducted analyses across wet and dry seasons, as well as varying altitudinal gradients. Our results showed that the diversity, structure, and taxonomic composition of eukaryotic microbial communities varied more with altitude than season, and the diversity of the communities first increased, then decreased, with increasing elevation. Distance-decay analysis showed that the correlation between eukaryotic microbial communities and environmental distance was stronger than the correlation between the microbial communities and geographical distance. Deterministic processes (homogeneous selection) dominated the construction of eukaryotic microbial communities, and water temperature, pH, and total phosphorus were the primary environmental factors that influenced the construction of eukaryotic microbial communities. These results expand our understanding of the characteristics of eukaryotic microbial communities in rivers on the Tibetan Plateau and provide clues to understanding the mechanisms that maintain eukaryotic microbial diversity in extreme environments.

Gastric emptying in patients with cholelithiasis and in patients following cholecystectomy: measurement by ultrasonography / 中华麻醉学杂志

Objective:To evaluate the gastric emptying in the patients with cholelithiasis and in the patients following cholecystectomy by ultrasonography.Methods:Thirty patients with cholelithiasis, 30 post-cholecystectomy patients and 30 healthy volunteers, of either sex, aged 18-64 yr, with body mass index of 18-30 kg/m 2, of American Society of Anesthesiologists Physical Status classification Ⅰor Ⅱ, were selected and divided into cholelithiasis group (group CH), post-cholecystectomy group (group PC) and healthy volunteer group (group HV). The indigestion scores of the enrolled subjects in the past 3 months were assessed; the subjects took a semi-solid test meal (300 kcal) in the fasting state, and the cross-sectional area (CSA) of the gastric sinus was measured using ultrasound at fasting (T 0) and 5, 15, 30, 45, 60, 90 and 120 min after the test meal was taken (T 1-7). The gastric emptying fraction at T 5, 6 was calculated. The gastric half-emptying time and remaining area of the gastric sinus at T 7 were also calculated. Results:Compared with group HV, dyspepsia scores were significantly increased within the past 3 months ( P<0.05), the CSA of the gastric sinus was increased at T 3-7, the gastric emptying fraction was decreased at T 5-6, the gastric half-emptying time was prolonged, and the remaining area of the gastric sinus was increased at T 7 in group CH and group PC ( P<0.05). Compared with group CH, the CSA of the gastric sinus was significantly increased at T 4-7, the gastric emptying fraction was decreased at T 5, 6, the gastric half-emptying time was prolonged, and the remaining area of the gastric sinus was increased at T 7 in group PC ( P<0.05). Conclusions:Gastric emptying time is longer in the patients with cholelithiasis and in the patients following cholecystectomy than in healthy subjects and is further prolonged after cholecystectomy in the patients.

Intracranial dissemination of glioblastoma multiforme: a case report and literature review.

Intracranial dissemination is rare among patients with glioblastoma multiforme (GBM). Very few GBM patients develop symptoms from intracranial dissemination, as most do not surviving long enough for intracranial dissemination to become clinically evident. Herein, we report a case of GBM in a 39-year-old woman who underwent surgical resection, concomitant chemoradiotherapy, and seven courses of adjuvant chemotherapy with temozolomide. The patient then complained of an instable gait and hearing loss. Imaging studies demonstrated that although the primary intracranial tumors were well-controlled by treatment, contralateral cerebellopontine angle seeding dissemination was present. The patient died 3 months after the diagnosis of seeding dissemination. In light of a previous report and our current case, heightened awareness could promote surgical strategies that minimize the possibility of dissemination, including avoiding ventricular entry or a no-touch strategy.

Removing miscellaneous heavy metals by all-in-one ion exchange-nanofiltration membrane.

The composition of wastewater containing heavy metal mixtures is often complex and poses a serious threat to human and environmental health. Effective removal of a variety of heavy metal ions with a single technology is challenging, and the conventional split integrated technologies require multi-step processing and a massive footprint. For the first time, we achieve hierarchically integrating ion exchange and nanofiltration into all-in-one "iNF" membranes. The iNF membrane has a hierarchical structure with an interfacial polymerization layer and an ion exchange layer, which can achieve highly efficient indiscriminate heavy metal ion removal, overcoming the defect that traditional nanofiltration membranes can only remove single metal cations or oxyanions. The ion exchange layer can remove heavy metal ions through sulfonic acid groups and quaternary amine groups. In addition, the ion exchange layer can be regenerated by electro-deionization, which is meaningful for sustainable membrane usage. This facile, scalable, and compact integrated process shows outstanding potential and universal applicability in complex wastewater treatment.

[Material basis and molecular mechanism of Angelicae Sinensis Radix in activating blood:based on computer-aided drug design].

Angelicae Sinensis Radix excels in activating blood, but the scientific mechanism has not been systematically analyzed, thus limiting the development of the medicinal. This study employed the computer-aided drug design methods, such as structural similarity-based target reverse prediction, complex network analysis, molecular docking, binding free energy calculation, cluster analysis, and ADMET(absorption, distribution, metabolism, excretion, toxicity) calculation, and enzyme activity assay in vitro, to explore the components and mechanism of Angelicae Sinensis Radix in activating blood. Target reverse prediction and complex network analysis yielded 40 potential anticoagulant targets of the medicinal. Gene Ontology(GO) term enrichment and Kyoto Encyclopedia of Genes and Genomes(KEGG) pathway enrichment analysis indicated that the targets mainly acted on the complement and coagulation cascade signaling pathway to exert the anticoagulant function. Among them, the key enzymes thrombin(THR) and coagulation factor Xa(FXa) in coagulation cascade and thrombosis were the drug targets for thromboembolic diseases. At the same time, molecular docking and cluster analysis showed that the medicinal had high selectivity for FXa. According to binding free energy score, 8 potential active components were selected for enzyme activity assay in vitro. The results demonstrated that 8 components inhibited THR and FXa, and the inhibition was stronger on FXa than on THR. The pharmacophore model of 8 active compounds was constructed, which suggested that the components had the common pharmacophore AAHH. The ADMET calculation result indicated that they had good pharmacokinetic properties and were safe. Based on target reverse prediction, complex network analysis, molecular docking and binding free energy calculation, anticoagulant activity in vitro, spatial binding conformation of molecules and targets, pharmacophore model construction, and ADMET calculation, this study preliminarily clarified the material basis and molecular mechanism of Angelicae Sinensis Radix in activating blood from the perspective of big data, and calculated the pharmacology and toxicology parameters of the active components. Our study, for the first time, revealed that the medicinal had obvious selectivity and pertinence for different coagulation proteins, reflecting the unique effect of different Chinese medicinals and the biological basis. Therefore, this study can provide clues for precision application of Angelicae Sinensis Radix and the development of the blood-activating components with modern technology.

Effects of controlled low central venous pressure on cerebral blood flow in patients undergoing open hepatectomy / 中华麻醉学杂志

Objective:To evaluate the effects of controlled low central venous pressure (CLCVP) on the cerebral blood flow in the patients undergoing open hepatectomy.Methods:Thirty American Society of Anesthesiologists Physical Status classification Ⅱ or Ⅲ patients of either sex, aged 18-60 yr, with body mass index of 18-30 kg/m 2, with Child-Pugh classification A and expected operation time of 2-4 h, undergoing elective open hepatectomy, were enrolled.After anesthesia induction, patients were placed at head-up tilt position, nitroglycerin 0.5-1.5 μg·kg -1·min -1 was infused, and furosamide 5-10 mg was intravenously injected when necessary to maintain CVP less than 5 cmH 2O during hepatectomy.After the end of hepatectomy, CLCVP was stopped, the infusion rate was increased to 10 ml·kg -1·h -1 with a crystalline gel ratio of 1∶2 to restore CVP to more than 5 cmH 2O.At 5 min after anesthesia induction (T 0), 5 min after head-up tilt (T 1), 5 and 15 min after CVP reaching the target (T 2, 3) and 5 min after the end of CLCVP (T 4), the blood flow of internal carotid artery was detected by ultrasound, and peak systolic velocity(IBVs), end diastolic velocity (IBVd)and vessel diameter of the internal carotid artery (ID)were measured by doppler ultrasound.Mean velocity [IBVm=(IBVs+ IBVd×2)÷3] and internal carotid artery blood flow [IBF=IBVm×π×(ID/2) 2×HR] were calculated.Heart rate (HR), mean arterial blood pressure (MAP), cardiac output (CO), stroke volume (SV), end-tidal pressure of carbon dioxide (P ETCO 2) and maximum airway pressure (P max) were recorded at each time point. Results:Compared with the baseline at T 0, MAP, CO, SV, IBVm and IBF were significantly decreased at T 2, 3 ( P<0.001), and no significant change was found in HR, P ETCO 2 and P max at T 1-4 ( P>0.05). The results of linear mixed-effects model analysis showed that the regression coefficients for CO, MAP, HR, and SV were 0.600 3, 0.022 88, 0.363 7, and 0.614 8, respectively ( P<0.05 or 0.01). Conclusions:CLCVP can decrease the cerebral blood flow in the patients, which is closely associated with decreased CO, MAP, HR and SV when used for open hepatectomy.

Material basis and molecular mechanism of Angelicae Sinensis Radix in activating blood:based on computer-aided drug design / 中国中药杂志

Angelicae Sinensis Radix excels in activating blood, but the scientific mechanism has not been systematically analyzed, thus limiting the development of the medicinal. This study employed the computer-aided drug design methods, such as structural similarity-based target reverse prediction, complex network analysis, molecular docking, binding free energy calculation, cluster analysis, and ADMET(absorption, distribution, metabolism, excretion, toxicity) calculation, and enzyme activity assay in vitro, to explore the components and mechanism of Angelicae Sinensis Radix in activating blood. Target reverse prediction and complex network analysis yielded 40 potential anticoagulant targets of the medicinal. Gene Ontology(GO) term enrichment and Kyoto Encyclopedia of Genes and Genomes(KEGG) pathway enrichment analysis indicated that the targets mainly acted on the complement and coagulation cascade signaling pathway to exert the anticoagulant function. Among them, the key enzymes thrombin(THR) and coagulation factor Xa(FXa) in coagulation cascade and thrombosis were the drug targets for thromboembolic diseases. At the same time, molecular docking and cluster analysis showed that the medicinal had high selectivity for FXa. According to binding free energy score, 8 potential active components were selected for enzyme activity assay in vitro. The results demonstrated that 8 components inhibited THR and FXa, and the inhibition was stronger on FXa than on THR. The pharmacophore model of 8 active compounds was constructed, which suggested that the components had the common pharmacophore AAHH. The ADMET calculation result indicated that they had good pharmacokinetic properties and were safe. Based on target reverse prediction, complex network analysis, molecular docking and binding free energy calculation, anticoagulant activity in vitro, spatial binding conformation of molecules and targets, pharmacophore model construction, and ADMET calculation, this study preliminarily clarified the material basis and molecular mechanism of Angelicae Sinensis Radix in activating blood from the perspective of big data, and calculated the pharmacology and toxicology parameters of the active components. Our study, for the first time, revealed that the medicinal had obvious selectivity and pertinence for different coagulation proteins, reflecting the unique effect of different Chinese medicinals and the biological basis. Therefore, this study can provide clues for precision application of Angelicae Sinensis Radix and the development of the blood-activating components with modern technology.

Effect of preoperative oral carbohydrate on gastric emptying in patients undergoing laparoscopic cholecystectomy / 中华麻醉学杂志

Objective:To evaluate the effect of preoperative oral carbohydrate on gastric emptying in the patients undergoing laparoscopic cholecystectomy.Methods:One hundred patients of both sexes, aged 18-64 yr, with body mass index of 18-30 kg/m 2, of American Society of Anesthesiologists physical status Ⅰ or Ⅱ, were divided into 2 groups ( n=50 each) using the random number table method: control group (group C) and preoperative oral carbohydrate group (group P). Patients underwent solid food fasting after 20: 00 on the night before surgery in both groups and drinking fasting after 21: 30 on the night before surgery in group C. Group P received 800 ml of 12.5% oral carbohydrate at 21: 30 on the night before surgery and 400 ml of oral similar carbohydrate from 5: 00 to 5: 30 in the morning before surgery.All the patients underwent ultrasound examination of the gastric sinus at 7: 30 on the operation day (2 h after oral carbohydrate, T 1) to determine the nature of gastric contents according to the qualitative analysis of images, and Perlas grade was performed, and the cross-sectional area (CSA) of the gastric sinus in a semi-sitting position and right lateral decubitus position was calculated, and gastric volume (GV) and gastric volume to weight ratio (GV/W) were calculated.For solids in the stomach or GV > 1.5 ml/kg was defined as a full stomach.Patients assessed as a full stomach at T 1 underwent antrum ultrasonography again before induction of anesthesia (at 3 h after oral carbohydrate, T 2). The occurrence of satiety at T 1 and T 2 in each group was recorded.The patient′s hunger score, thirst score, and satisfaction score during fasting were recorded at T 2.The reflux aspiration, occurrence of nausea and vomiting at 24 h after operation, postoperative time to first flatus and postoperative total length of hospital stay were recorded. Results:Compared with group C, the CSA in a semi-sitting position, CSA, GV and GV/W ratio in a right lateral decubitus position, incidence of satiety, and Perlas grade were significantly increased at T 1 ( P<0.05), no significant change was found in the incidence of satiety at T 2 ( P>0.05), preoperative hunger and thirst scores were significantly decreased, satisfaction scores were increased, the incidence of nausea and vomiting was decreased at 24 h after surgery, and the postoperative time to first flatus was shortened ( P<0.05), and no significant change in the postoperative total length of hospital stay was found in group P ( P>0.05). Conclusions:Oral carbohydrates before laparoscopic cholecystectomy may result in delayed gastric emptying in the patients with cholelithiasis, and the time window for oral carbohydrates can be appropriately shifted forward (3 h before surgery).

Salmonella Osteomyelitis in Adults: A Systematic Review.

The aim of this systematic review was to characterize the clinical features of adults with Salmonella osteomyelitis and summarize diagnosis and treatment methods to provide guidance for clinicians. This systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We conducted a literature search in the PubMed, EMBASE, and Cochrane Library databases. Article screening and data extraction were performed by two reviewers individually. All the included studies were independently evaluated by two reviewers using the Methodological Index for Non-Randomized Studies (MINORS) criteria. A total of 67 articles published between 1970 and 2019 were selected, which include 69 patients with an average age of 47.5 years (range, 18-79).The majority of cases (47.76%) occurred in immunocompetent adults without common risk factors. Aspiration and biopsy cultures were all positive in Salmonella osteomyelitis patients who underwent aspiration or biopsy. All infections were monomicrobial, and a total of 12 different serotypes were identified. The three most commonly reported Salmonella serotypes were Salmonella typhi (19 cases), Salmonella typhimurium (12 cases), and Salmonella enteritidis (11 cases). Only 12 of the 67 cases in our data (17.91%) had diarrhea symptoms, and 44 of the 67 cases (65.67%) had fever symptoms. Fifty-nine of the 67 cases (88.06%) had local inflammatory manifestations, such as erythema, swelling, and tenderness in the affected area. The commonly reported involved sites were the vertebrae, femur, and tibia. Antibiotic therapy alone was utilized in 30 cases, and 24 patients (80.00%) were eventually cured. In total, 75.68% of patients achieved satisfactory results after treatment with surgery and antibiotics. Third-generation cephalosporins were most commonly utilized, and antibiotic treatment was administered for an average of 11.3 weeks (95% CI, 8.31-14.37 weeks). Salmonella osteomyelitis should be considered in patients without any common risk factors. Aspiration or biopsy can facilitate the identification of pathogens to guide antibiotic choice. Empirical therapy with a third-generation cephalosporin is recommended until the susceptibility of the strain is determined.

An Improved Approach to Direct Simulation of an Actual Almen Shot Peening Intensity Test with a Large Number of Shots.

In existing simulations of the Almen intensity test, arc height is indirectly obtained by an equivalent method including a representative cell, a few shots and equivalent loading. Most of these equivalent methods cannot consider the transverse deformation of the strip, the complex stress state of the plastic hardening layer and process parameters, resulting in deviation from the actual test. This paper introduces an improved and experimentally validated discrete element model (DEM)-finite element model (FEM) to predict the actual Almen intensity. The improvement of this model is mainly reflected in the large and real number of shots involved in the actual Almen intensity test, shot-shot interactions, and real-size solid finite element model of the Almen strip. A new method for calculating the shot stream is proposed based on the test and considering test process parameters such as the mass flowrate, nozzle movement speed and nozzle-workpiece distance. The shot stream impacting the strip with a fully restrained underside was first simulated in improved DEM-FEM to bring the forming energy. As a second step, an implicit solver of the Almen strip FEM calculates the spring-back to simulate strip removal from the holder. The results achieved by the present approach are compared with the results obtained by the experimental results and those in the literature. The results show that the arc height and Almen intensity obtained by the present approach match much better with the literature than the traditional method. Some new results obtained by the improved coupling DEM-FEM method are presented. The influences of the transverse deformation and surface plastic layer on the deformation of the Almen strip are discussed. This improved method provides an alternative characterization method for precision peen forming simulation.

Clinical outcomes and prognostic factors in bloodstream infections due to extended-spectrum ß-lactamase-producing Enterobacteriaceae among patients with malignancy: a meta-analysis.

BACKGROUND: The colonization of Extended-spectrum ß-lactamase-producing Enterobacteriaceae (ESBL-PE) in bloodstream infections (BSIs) has been increased dramatically worldwide, and it was associated with worse clinical outcomes in patients with malignancy. We performed the meta-analysis to investigate the prognosis and risk factors in BSIs caused by ESBL-PE in oncological patients. METHODS: PubMed, EMBASE, and Cochrane Library were searched for related studies. All-cause mortality was considered as the primary outcome. Subgroup analyses, meta-regression analyses, and sensitivity analysis were used to investigate heterogeneity and reliability in results. RESULTS: 6,729 patients from 25 studies were eligible. Six studies enrolled oncological patients with BSIs caused by ESBL-PE only, while 19 studies both enrolled ESBL-PE and non-ESBL-PE infections. The results showed that BSIs caused by ESBL-PE in patients with malignancy was associated with higher mortality than non-ESBL-PE infections (RR = 2.21, 95% CI: 1.60-3.06, P < 0.001), with a significant between-study heterogeneity (I2 =78.3%, P < 0.001). Subgroup analyses showed that children (RR = 2.80, 95% CI: 2.29-3.43, P < 0.001) and hematological malignancy (RR = 3.20, 95% CI: 2.54-4.03, P < 0.001) were associated with a higher mortality. Severe sepsis/ septic shock, pneumonia, and ICU admission were the most common predictors of mortality. CONCLUSIONS: Our study identified that BSIs caused by ESBL-PE in patients with malignancy were associated with worse clinical outcomes compared with non-ESBL-PE infections. Furthermore, children and hematological malignancy were associated with higher mortality. Severe sepsis/ septic shock, pneumonia, and ICU admission were the most common predictors of mortality.

Rare Occurrence of Acute Hematogenous Periprosthetic Joint Infection Due to Fusobacterium Nucleatum in the Background of a Dental Procedure: A Case Report.

OBJECTIVE: Fusobacterium nucleatum is an anaerobic gram-negative bacilli that is one of the oral and other mucosal surface microbiota. It involves a wide range of human diseases and was first found in periodontal diseases, but reports of bone-related infections caused by F. nucleatum are rare, especially periprosthetic joint infections (PJI). METHODS: Here, we present the first case of acute hematogenous PJI of the hip joint caused by F. nucleatum, and debridement, antibiotics, and implant retention (DAIR) was performed. RESULTS: The patient was successfully treated with DAIR, identification of isolates by metagenomics next-generation sequencing was confirmed by polymerase chain reaction. CONCLUSIONS: For stable acute hematogenous PJI after hip replacement, quick and accurate diagnosis, the identification of pathogenic microorganisms, and the use of DAIR combined with sufficient sensitive antibiotics have a certain clinical effect and can achieve the purpose of both preserving the prosthesis and infection control.

Comparative cellular, physiological and transcriptome analyses reveal the potential easy dehulling mechanism of rice-tartary buckwheat (Fagopyrum Tararicum).

BACKGROUND: Tartary buckwheat has gained popularity in the food marketplace due to its abundant nutrients and high bioactive flavonoid content. However, its difficult dehulling process has severely restricted its food processing industry development. Rice-tartary buckwheat, a rare local variety, is very easily dehulled, but the cellular, physiological and molecular mechanisms responsible for this easy dehulling remains largely unclear. RESULTS: In this study, we integrated analyses of the comparative cellular, physiological, transcriptome, and gene coexpression network to insight into the reason that rice-tartary buckwheat is easy to dehull. Compared to normal tartary buckwheat, rice-tartary buckwheat has significantly brittler and thinner hull, and thinner cell wall in hull sclerenchyma cells. Furthermore, the cellulose, hemicellulose, and lignin contents of rice-tartary buckwheat hull were significantly lower than those in all or part of the tested normal tartary buckwheat cultivars, respectively, and the significant difference in cellulose and hemicellulose contents between rice-tartary buckwheat and normal tartary buckwheat began at 10 days after pollination (DAP). Comparative transcriptome analysis identified a total of 9250 differentially expressed genes (DEGs) between the rice- and normal-tartary buckwheat hulls at four different development stages. Weighted gene coexpression network analysis (WGCNA) of all DEGs identified a key module associated with the formation of the hull difference between rice- and normal-tartary buckwheat. In this specific module, many secondary cell wall (SCW) biosynthesis regulatory and structural genes, which involved in cellulose and hemicellulose biosynthesis, were identified as hub genes and displayed coexpression. These identified hub genes of SCW biosynthesis were significantly lower expression in rice-tartary buckwheat hull than in normal tartary buckwheat at the early hull development stages. Among them, the expression of 17 SCW biosynthesis relative-hub genes were further verified by quantitative real-time polymerase chain reaction (qRT-PCR). CONCLUSIONS: Our results showed that the lower expression of SCW biosynthesis regulatory and structural genes in rice-tartary buckwheat hull in the early development stages contributes to its easy dehulling by reducing the content of cell wall chemical components, which further effects the cell wall thickness of hull sclerenchyma cells, and hull thickness and mechanical strength.

Integrally Cooperative Spatio-Temporal Feature Representation of Motion Joints for Action Recognition.

In contemporary research on human action recognition, most methods separately consider the movement features of each joint. However, they ignore that human action is a result of integrally cooperative movement of each joint. Regarding the problem, this paper proposes an action feature representation, called Motion Collaborative Spatio-Temporal Vector (MCSTV) and Motion Spatio-Temporal Map (MSTM). MCSTV comprehensively considers the integral and cooperative between the motion joints. MCSTV weighted accumulates limbs' motion vector to form a new vector to account for the movement features of human action. To describe the action more comprehensively and accurately, we extract key motion energy by key information extraction based on inter-frame energy fluctuation, project the energy to three orthogonal axes and stitch them in temporal series to construct the MSTM. To combine the advantages of MSTM and MCSTV, we propose Multi-Target Subspace Learning (MTSL). MTSL projects MSTM and MCSTV into a common subspace and makes them complement each other. The results on MSR-Action3D and UTD-MHAD show that our method has higher recognition accuracy than most existing human action recognition algorithms.

Cup-Cage Solution for Massive Acetabular Defects: A Systematic Review and Meta-Analysis.

Our systematic review compiled multiple studies and evaluated survivorship and clinical outcomes of cup-cage construct usage in the management of massive acetabular bone defects. This systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Various combinations of "acetabular", "pelvis", "cup cage" and their corresponding synonyms were used to search relevant articles in the Cochrane, EMBASE, and PubMed databases. Basic information of the functional scores, implant revision rate, and complication rate were selected as outcomes for analysis. Finally, a total of 11 articles published between 1999 and 2019 were selected, which include 232 patients with an average age of 68.5 years (range, 30-90). The mean follow-up period was 48.85 months (range, 1-140). Our study shows that the cup-cage construct has a good clinical outcome with a low revision rate and a low complication rate. Improved clinical outcomes of cup-cage constructs were seen with a revision rate of 8% and an all-cause complication rate of 20%. The most commonly reported complication was dislocation, followed by aseptic loosening, infection, and nerve injuries. In summary, it is a promising method for managing large acetabular bone defects in total hip revision.