Ependymoblastoma with pulmonary metastasis in an adolescent: A case report.

Ependymoblastoma is a rare embryonal neoplasm of the nervous system, and the entity is even rare with distant metastasis. This case can help refine the existing literature and provide lessons for the management of other patients with ependymoblastoma. The present case concerns an adolescent with supratentorial ependymoblastoma, who received gross-total resection (GTR), postoperative radiotherapy, and six cycles of chemotherapy, with disease-free survival (DFS) of about 5.3 years. Subsequently, pulmonary metastasis occurred, but no intracranial lesion was found. Finally, combined treatment with radiotherapy and chemotherapy significantly reduced the lung lesions, with progression-free survival (PFS) of 10 months and long-term survival of 6.3 years. This case indicates that the lung metastases of ependymoblastoma are relatively sensitive to radiation, but lung metastases have not completely disappeared. Perhaps, increasing the radiation dose to lung metastases can improve the efficacy, which is worth exploring.

Construction and Application of a Medical-Grade Wireless Monitoring System for Physiological Signals at General Wards.

Physiological signals can contain abundant personalized information and indicate health status and disease deterioration. However, in current medical practice, clinicians working in the general wards are usually lack of plentiful means and tools to continuously monitor the physiological signals of the inpatients. To address this problem, we here presented a medical-grade wireless monitoring system based on wearable and artificial intelligence technology. The system consists of a multi-sensor wearable device, database servers and user interfaces. It can monitor physiological signals such as electrocardiography and respiration and transmit data wirelessly. We highly integrated the system with the existing hospital information system and explored a set of processes of physiological signal acquisition, storage, analysis, and combination with electronic health records. Multi-scale information extracted from physiological signals and related to the deterioration or abnormality of patients could be shown on the user interfaces, while a variety of reports could be provided daily based on time-series signal processing technology and machine learning to make more information accessible to clinicians. Apart from an initial attempt to implement the system in a realistic clinical environment, we also conducted a preliminary validation of the core processes in the workflow. The heart rate veracity validation of 22 patient volunteers showed that the system had a great consistency with ECG Holter, and bias for heart rate was 0.04 (95% confidence interval: -7.34 to 7.42) beats per minute. The Bland-Altman analysis showed that 98.52% of the points were located between Mean ± 1.96SD. This system has been deployed in the general wards of the Hyperbaric Oxygen Department and Respiratory Medicine Department and has collected more than 1000 cases from the clinic. The whole system will continue to be updated based on clinical feedback. It has been demonstrated that this system can provide reliable physiological monitoring for patients in general wards and has the potential to generate more personalized pathophysiological information related to disease diagnosis and treatment from the continuously monitored physiological data.

Preventive application of low molecular weight heparin ameliorates peripherally inserted central catheter-related venous thrombosis.

OBJECTIVE: Peripherally inserted central catheter (PICC) is being increasingly used in critical care settings. However, PICC is associated with various complications, particularly venous thrombosis. Our aim was to observe the effects of preventive application of low molecular weight heparin on venous thrombosis in a PICC model. METHODS: All rabbits were randomly divided into four groups: a control group, and low/medium/high concentration of low molecular weight heparin groups. All rabbits were injected prophylactically with normal saline or low molecular weight heparin once a day for 7 days. A PICC model was constructed. The pathologic changes of ear vein, anterior vena cava, and venous thrombosis were investigated using hematoxylin and eosin (H&E). Biochemical testing was performed including prothrombin time (PT), activated partial thromboplastin time (APTT), and thrombin time (TT). Serum D-dimer (D2D) and fibrinogen (FG) levels were detected using Enzyme-linked immunosorbent assay (ELISA). RESULTS: X-ray results showed that the PICC model was successfully constructed. H&E results showed that preventive application of low molecular weight heparin significantly ameliorated the pathologic damage to ear vein and anterior vena cava in the PICC model. Furthermore, we found that preventive application of low molecular weight heparin inhibited venous thrombosis in the model by H&E stain. Moreover, it significantly reduced serum FG and D2D levels in PICC model. Biochemical testing results showed that PT, APTT, and TT were significantly elevated in the PICC model. CONCLUSION: Our findings revealed that preventive application of low molecular weight heparin significantly ameliorates venous thrombosis in a PICC model.

[Study on the accuracy of cardiopulmonary physiological measurements by a wearable physiological monitoring system under different activity conditions].

This paper aims to study the accuracy of cardiopulmonary physiological parameters measurement under different exercise intensity in the accompanying (wearable) physiological parameter monitoring system. SensEcho, an accompanying physiological parameter monitoring system, and CORTEX METALYZER 3B, a cardiopulmonary function testing system, were used to simultaneously collect the cardiopulmonary physiological parameters of 28 healthy volunteers (17 males and 11 females) in various exercise states, such as standing, lying down and Bruce treadmill exercise. Bland-Altman analysis, correlation analysis and other methods, from the perspective of group and individual, were used to contrast and analyze the two types of equipment to measure parameters of heart rate and breathing rate. The results of group analysis showed that the heart rate and respiratory rate data box charts collected by the two devices were highly consistent. The heart rate difference was (-0.407 ± 3.380) times/min, and the respiratory rate difference was (-0.560 ± 7.047) times/min. The difference was very small. The Bland-Altman plot of the heart rate and respiratory rate in each experimental stage showed that the proportion of mean ± 2SD was 96.86% and 95.29%, respectively. The results of individual analysis showed that the correlation coefficients of the whole-process heart rate and respiratory rate data were all greater than 0.9. In conclusion, SensEcho, as an accompanying physiological parameter monitoring system, can accurately measure the human heart rate, respiration rate and other key cardiopulmonary physiological parameters under various sports conditions. It can maintain good stability under various sports conditions and meet the requirements of continuous physiological signal collection and analysis application under sports conditions.

Fibroblast growth factor-2 promotes the function of tendon-derived stem cells in Achilles tendon restoration in an Achilles tendon injury rat model.

The prognosis of Achilles tendon rupture is often unsatisfactory. Proliferative fibrous tissues and disordered collagen bundles make it difficult to guarantee normal biomechanical properties. The present study aimed to investigate the role of fibroblast growth factor-2 (FGF-2) in promoting the ability of human tendon-derived stem cells (hTDSCs) to treat Achilles tendon injury. hTDSCs were isolated from fetal Achilles tendon tissue and verified using fluorescence activated cell sorting analysis and multi-directional differentiation. The cells were then transfected with a lentivirus carrying the FGF2 gene. In vitro, FGF2 overexpression increased the expression of Collagen Type III Alpha 1 Chain (collagen-III) and scleraxis BHLH transcription factor (SCXA) significantly. Additionally, FGF-2-hTDSCs were transplanted into a rat Achilles tendon defect model. The in vivo results showed that the Achilles tendon tissue in the FGF-2 group secreted more extracellular matrix and produced collagen fibers that showed a more orderly arrangement. The expression of collagen-I and III in the FGF-2 group was significantly increased at 4 weeks postoperatively compared with the control group. Moreover, biomechanical tests showed that the failure load of FGF-2 group was higher at 4 and 8 weeks postoperatively than that of the controls. FGF-2 group had the highest stiffness in the early postoperative period, but showed no significant difference in the middle and late postoperative periods compared with that of the controls. In conclusion, FGF2 gene-modified hTDSCs promoted healing of Achilles tendon injury more effectively than hTDSCs alone.

Surface-enhanced Raman scattering behaviour of 4-mercaptophenyl boronic acid on assembled silver nanoparticles.

Molecular recognition based on specific intermolecular interactions is essential for the design of sensors with high selectivity. Herein, we report the surface-enhanced Raman scattering (SERS) behaviour of 4-mercaptophenyl boronic acid (MPBA) on self-assembled silver nanoparticles and its interaction with d-glucose. It is demonstrated that the orientation and existing form of the MPBA strongly depend on the pH value of the media. The surface-immobilized MPBA can be reversibly associated with OH(-) in solution, along with a molecular orientation alteration. A self-condensation reaction among the OH(-)-associated MPBA molecules results in irreversible conversion of OH(-)-associated MPBA to anhydride, which may hinder the interaction between d-glucose and the B-moiety of MPBA. However, the self-condensation reaction can be diminished under optimized conditions. By taking advantage of the difference in the kinetics of dissociation of the OH(-)-associated MPBA and d-glucose-associated MPBA in acidic media, a proper scheme of the SERS detection of d-glucose is proposed to illuminate the spectral interference of OH(-)-associated MPBA, which exhibits SERS features similar to those of d-glucose-associated MPBA species. Based on those strategies, the SERS detection of d-glucose can be achieved in the physiologically-relevant concentration range.